Clinical Outcomes of Median Nerve Release in Carpal Tunnel Syndrome with and without Cervical Radiculopathy

Introduction: Carpal tunnel syndrome (CTS) is a symptomatic compression neuropathy of the median nerve in the wrist. This study aimed to evaluate the clinical outcomes of median nerve release in CTS with and without cervical radiculopathy (CR) in patients referred to orthopedic research centers in Sari, Iran, to assess whether the CR patients need to be referred for proximal decompression spine surgery. Methods: The patients were divided in two groups of 30 (CTS with and without cervical radiculopathy). The patients in the CR group were selected based on involvement in electromyography (EMG)/nerve conduction velocity (NCV). This study examined the variables of grip and pinch strength, QuickDASH questionnaire, Boston symptom severity scale (BQ-SS), Boston Questionnaire-Functional Scale (BQ-FS), and VAS index before surgery, three months and six months after surgery. Results: The studied scores (grip and pinch strength, BQ-FS and BQ-SS, QuickDASH, and VAS) had a significant decrease in three and six months after surgery between the two groups (P<0.05). There was no significant difference between the two groups in reduction rate (P>0.05). The correlation between BQ-SS and VAS in studied patients was significant in different periods. So, that BQ-SS and VAS scores decreased after median nerve release in both groups, but the decreasing trend was significantly higher in the CTS group without CR than in the CTS group with CR (P<0.001). Conclusion: The median nerve release can be effective in the two groups, and a six-month follow-up in the patients with CR and it revealed there was no need for referral for proximal decompression spine surgery.