Results of endoscopically assisted decompression of the ulnar nerve in the elbow region

Czech version

Authors: H. Zítek ¹; I. Humhej ^1,2; D. Kachlík ²; M. Sameš ¹
Authors‘ workplace: Neurochirurgická klinika FZS UJEP, a KZ, a. s. – Masarykovy nemocnice, v Ústí nad Labem, o. z. ¹; Ústav anatomie 2. LF UK, Praha ²
Published in: Cesk Slov Neurol N 2021; 84/117(2): 199-204
Category: Original Paper
doi: https://doi.org/10.48095/cccsnn2021199

Overview

Aim: The aim of the study was to analyse results of endoscopically assisted decompression of the ulnar nerve in the cubital tunnel in a substantial number of patients with cubital tunnel syndrome. Materials and methods: We analysed a set of 204 patients with the diagnosis of cubital tunnel syndrome, in whom we performed 213 endoscopically assisted decompressions of the ulnar nerve in the cubital tunnel from May 2007 until December 2016. Firstly, the patients were followed for 3 months after surgery (70% of the patients) and secondly, we evaluated long-term results based on our own questionnaire completed by 55% of patients. Results: Out of 149 followed cases (141 patients), improvement or significant improvement was found in 90% of them. Nine percent of the patients described stationary symptoms and 1% felt worse. Postoperative electrophysiological examination was performed in 137 patients. Results were as follows: improvement in 89%, no change in 10%, and worsening in 1% (N = 2) of the cases. Both of these worsening’s were temporary and subsequent electromyography showed improvement after 10 and 15 months, respectively, without a need for revision surgery also due to the improved clinical condition. We obtained the completed survey from 115 patients (121 surgeries) with a follow-up of 14–129 months, 60 months on average. Overall improvement of the operated hand was expressed by 92% of patients, while 89.5% of them described a satisfactory effect of the procedure and its course. We failed to prove a statistically significant relationship between the severity of preoperative symptoms (McGowan score or electromyography finding) and the patient’s postoperative satisfaction. On the contrary, we found a strong relationship between the patient’s satisfaction after surgery and subjective return of hand sensitivity or improvement of grip strength. Conclusion: Our study proves that endoscopically assisted decompression of the ulnar nerve in cubital tunnel represents a safe and reliable alternative to other surgical procedures of ulnar nerve decompression. With the correct indication provided, the procedure leads to long-term improvement of the symptoms of cubital tunnel syndrome in vast majority of patients, including patients with a severe nerve lesion.

Keywords:

cubital tunnel syndrome – ulnar nerve – surgical decompression – endoscopy – questionnaire

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