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Dützmann S, Martin KD, Sobottka S, Marquardt G, Schackert G, Seifert V, Krishnan KG. Open vs Retractor-Endoscopic In Situ Decompression of the Ulnar Nerve in Cubital Tunnel Syndrome. Neurosurgery 2012; 72:605-16; discussion 614-6. [DOI: 10.1227/neu.0b013e3182846dbd] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
Both open ulnar nerve decompression and retractor-endoscopic ulnar nerve decompression have been shown to yield good results. However, a comparative evaluation of the techniques is lacking.
OBJECTIVE:
To compare the results of open and endoscopic surgery in cubital tunnel syndrome.
METHODS:
One hundred fourteen patients undergoing open (n = 59) or endoscopic (n = 55) decompression of the ulnar nerve for cubital tunnel syndrome were retrospectively compared. The long- and short-term outcomes were compared with respect to the time until return to full activity and the duration of postoperative pain. Additionally, matched pairs between the 2 groups were chosen for analysis (n = 34).
RESULTS:
Long-term results in the open vs endoscopic groups were as follows: excellent results, 54.2% vs 56.4%; good results, 23.8% vs 32.7%; fair results, 20.3% vs 9.1%; and poor results, 1.7% vs 1.8%, respectively. For the matched pairs, the results had similar significance levels (P = .84). The times until return to full activity in the open vs the endoscopic groups were as follows: 2 to 7 days, 18.6% vs 76.4%; 7 to 14 days, 55.9% vs 10.9%; and > 14 days, 25.4% vs 12.7% (P < .001 between nonmatched and matched pairs). The durations of postoperative pain in the open vs the endoscopic groups were as follows: 1 to 3 days, 45.8% vs 67.3%; 3 to 10 days, 42.5% vs 25.4%; and > 10 days, 11.7% vs 7.3% (P =.04 for nonmatched and P = .05 for matched pairs).
CONCLUSION:
There are no significant differences in long-term outcomes after open and retractor-endoscopic in situ decompression of the ulnar nerve in cubital tunnel syndrome. The short-term results are significantly better in endoscopic surgery.
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Affiliation(s)
- Stephan Dützmann
- Department of Neurological Surgery, Johann Wolfgang von Goethe University, Frankfurt/Main, Germany
| | - K. Daniel Martin
- Department of Neurological Surgery, Carl Gustav Carus University Hospital, Dresden, Germany
| | - Stephan Sobottka
- Department of Neurological Surgery, Carl Gustav Carus University Hospital, Dresden, Germany
| | - Gerhard Marquardt
- Department of Neurological Surgery, Johann Wolfgang von Goethe University, Frankfurt/Main, Germany
| | - Gabriele Schackert
- Department of Neurological Surgery, Carl Gustav Carus University Hospital, Dresden, Germany
| | - Volker Seifert
- Department of Neurological Surgery, Johann Wolfgang von Goethe University, Frankfurt/Main, Germany
| | - Kartik G. Krishnan
- Department of Neurological Surgery, Justus Liebig University, Giessen, Germany
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