手根管症候群の診断と治療に対する私たちの方針

概要

論文の詳細を見る
Clinical symptoms and diagnostic features with operative indication are investigated in 111 cases (15 male and 96 female) of carpal tunnel syndrome (CTS) seen at our institution, of which 53 cases had bilateral CTS. CTS was detected in the non-dominant side hand in 50 cases. Conservative care was selected in 58 cases with favorable recovery, whereas operative treatment was indicated in 53 severely affected cases with excellent result after direct microscopic surgery. Atypical patterns of sensory disturbance were shown in 50% of our series. The positive rate was 50% with Tinel's sign and approximately 90% with Phalen's sign. Nerve conduction studies are the most reliable method for diagnosis of CTS by detecting demyelination and axonopathy. MRI showed decreased volume of the carpal tunnel with T1 weighted images and increased signal intensity of the flattened median nerve at the affected wrists with T2 weighted images. These findings showed a favorable improvement in T2 weighted images with normalized signal intensity of the round-shaped median nerve in the increased space of the carpal tunnel after surgery.
日本脊髄外科学会の論文
2002-07-31