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A Clinical Application Study on Ultrasonographic Cross-Sectional Area of Median nerve at the Wrist in Patients with Carpal Tunnel Syndrome

To determine the usefulness of ultrasonographic cross-sectional area of median nerve at the wrist (CSA-W) by evaluating the correlation between ultrasonographic CSA-W data and electrophysiologic severity in patients who underwent endoscopic carpal tunnel release for carpal tunnel syndrome (CTS). To confirm whether the changes in CSA-W after surgery predict the improvement of symptoms after surgery in CTS patients.

From January 2021 to March 2023, 135 patients, 192 wrists underwent endoscopic carpal tunnel release. We performed the ultrasonography and electrophysiologic study for both wrists preoperatively. The electrophysiologic severity was divided into non-severe group and severe group and the CSA-W in each group was compared and analyzed. Changes in the CSA-W of the median nerve before and after surgery were analyzed for 22 patients who had follow-up measurement of CSA-W of median nerve at 3 months after surgery.

The CSA-W of median nerve did not show a statistically significant difference in each electrophysiologic severity but showed a statistically significant difference between the non-severe group (14.07 ± 3.17 mm2) and the severe group (17.90 ± 5.06 mm2). The difference in the severity of the electrophysiologic tests of both wrists and the difference in the CSA-W of median nerve tended to increase. There was no significant change in Median nerve CSA-W after surgery on follow-up ultrasound at 3 months after surgery.

Although CSA-W of Median nerve is not directly correlated with the severity of CTS, it could be a useful parameter in predicting the severity of CTS. Changes in CSA after surgery cannot predict the improvement of symptoms after surgery in carpal tunnel syndrome patients.

carpal tunnel syndrome, ultrasound, median nerve cross-sectional area, electrophysiologic test