Turkish Neurosurgery
Comparison of Short-Term Clinical and Electrophysiological Outcomes of Local Steroid Injection and Surgical Decompression in The Treatment of Carpal Tunnel Syndrome Running title: Steroid Injection and Surgical Decompression in Carpal Tunnel Syndrome
Ahmet Gurhan Gurcay1, Ozgur Zeliha Karaahmet2, Oktay Gurcan1, Atilla Kazanci1, Pınar Bora Karsli2, Ebru Karaca Umay2, Sevtap Acer2, Ece Unlu2
1Ankara Ataturk Education and Research Hospital, Neurosurgery, Ankara,
2Ankara Diskapi Yildirim Beyazit Education and Researh Hospital , Physical Medicine and Rehabilitation, Ankara,
DOI: 10.5137/1019-5149.JTN.15936-15.0

Aim:To investigate the effectiveness of local steroid injection and surgical decompression in the treatment of patients with severe carpal tunnel syndrome (CTS) and also to compare short-term outcomes using clinical and electrophysiological criteria.Material and Methods:The patients diagnosed as severe CTS were divided into two groups. Group 1 received local steroid injection and Group 2 underwent surgical decompression. Boston Questionnaire that consists of two sections as Boston Symptom Severity Scale (BSS) and Functional Status Scale (FSS) items was completed by the patients.Results:A total of 33 patients completed the study. Since two patients had bilateral severe CTS, a total of 35 hands were evaluated in the study. In the steroid injection therapy group, a significant difference was recorded between some pre- and post-treatment clinical parameters (BSS and FSS scores) and all electrophysiological parameters excluding motor conduction velocities. In the surgical decompression group, a statistically significant difference was found between pre and post-treatment BSS scores and all electrophysiological parameters excluding motor conduction velocity and distal latency. However intergroup differences were not statistically significant as for all clinical and electrophysiological parameters (BSS, FSS, sensory amplitude, sensory conduction velocity, distal latency, motor amplitude, motor conduction velocity).Conclusion:It has been determined that in the treatment of severe CTS, steroid injection and surgical decompression achieved favourable improvements in clinical and electrophysiological parameters within a short-term without superiority of one treatment over other. Therefore, in patients in whom surgical decompression can not be applied, local steroid injection can be recommended as a less invasive and a promising treatment alternative.

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