Outcome of Late Neurolysis on Median and Cubital Nerve Neuropathies: Insights from A Preliminary Prospective Study

Abstract

Background: Nerve decompression represents the treatment in which a nerve is freed from compressing surrounding. It should be ideally performed before neural changes become irreversible following long-term entrapment. No consensus exists on a critical time limit that would make surgery worthwhile. This study aims to investigate whether or not late (12 months after occurrence of symptoms) nerve decompression has still a positive impact on patient’s symptoms. Methods: This prospective study included 16 patients with carpal tunnel syndrome (8) or ulnar nerve entrapment (8) lasting for more than 12 months. Symptoms, motor and sensory functions were assessed before surgery, at 3,6 and 12 months after nerve decompression. Results: After median nerve decompression, pain decreased by 85%. Paresthesia resolved in all patients and nighttime symptoms decreased in 83% cases. Following ulnar decompression, pain decreased by 75 % and numbness resolved in 87% patients. Subjective sensibility increased by 25%, attested with Ten test. Measure of 2-PD decreased by 60% when compared to preoperative values. Grip strength improved to 40%. Conclusion: Despite uncomplete recovery one year after surgery, we believe that nerve decompressions should be indented even in case of chronic symptoms.