Long-Term Clinical Outcomes and Patient Satisfaction Following Ultrasound-Guided Hydrodissection for Carpal Tunnel Syndrome: A Comprehensive Reviews
Long-Term Outcomes and Satisfaction After Ultrasound-Guided Hydrodissection for CTS
DOI:
https://doi.org/10.31661/gmj.v14i.3638Keywords:
Carpal Tunnel Syndrome; Hydrodissection; Ultrasound-Guided Therapy; Median Nerve; PainAbstract
Carpal Tunnel Syndrome (CTS) is a prevalent condition caused by compression of the median nerve, leading to symptoms such as pain, numbness, and weakness in the hand. Traditional treatments, including splinting, corticosteroid injections, and surgery, offer varying degrees of symptom relief but are often associated with limitations such as short-term efficacy or long recovery times. Ultrasound-Guided Hydrodissection (USGH) has emerged as a minimally invasive alternative for treating CTS, utilizing real-time ultrasound imaging to guide fluid injection around the median nerve, reducing nerve compression and enhancing nerve gliding. This procedure has gained attention due to its precision, reduced complication rates, and faster recovery compared to surgical interventions. This review explores the long-term clinical outcomes and patient satisfaction associated with USGH for CTS. The analysis reveals that USGH provides sustained symptom relief, with patients experiencing reductions in pain, improved functional outcomes, and enhanced nerve conduction for up to a year or more. Patients report high satisfaction levels, largely attributed to the minimally invasive nature of USGH, shorter recovery times, and minimal postoperative discomfort. While most patients benefit from long-term symptom relief, some experience recurrence of symptoms after several months, though re-treatment remains a viable option. Complications associated with USGH are rare and typically minor, including temporary pain, swelling, or bruising at the injection site. Serious complications, such as nerve damage or infection, are infrequent due to the precision afforded by ultrasound guidance. Future research should focus on randomized controlled trials and the integration of regenerative medicine to improve long-term outcomes.
References
Omole AE, Awosika A, Khan A, Adabanya U, Anand N, Patel T, et al. An Integrated Review of Carpal Tunnel Syndrome: New Insights to an Old Problem. Cureus. 2023 Jun 8;15(6):e40145.
https://doi.org/10.7759/cureus.40145
Padua L, Cuccagna C, Giovannini S, Coraci D, Pelosi L, Loreti C, et al. Carpal tunnel syndrome: updated evidence and new questions. Lancet Neurol. 2023 Mar;22(3):255-67.
https://doi.org/10.1016/S1474-4422(22)00432-X
PMid:36525982
Atroshi I, Gummesson C, Johnsson R, Sprinchorn A. Symptoms, disability, and quality of life in patients with carpal tunnel syndrome. J Hand Surg. 1999;24(2):398-404.
https://doi.org/10.1016/S0363-5023(99)70014-6
PMid:10194028
Erickson M, Lawrence M, Jansen CWS, Coker D, Amadio P, Cleary C. Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Hand and Upper Extremity Physical Therapy and the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2019 May;49(5):CPG1-85.
https://doi.org/10.2519/jospt.2019.0301
PMid:31039690
Por-Bozrg M, Mir M, Ebrahimi P, Darban YM, Zohrevand A, Mohammadi TC, et al. Comparison of open surgery versus ultrasound guided median nerve hydrodissection with Triamcinolone acetonide in treatment of carpal tunnel syndrome. Life Sci Stud J. 2023 Jul 31;1(2):83-8.
Schrier VJMM, Brault JS, Amadio PC. Ultrasound‐GuidedHydrodissection With Corticosteroid Injection in the Treatment of Carpal Tunnel Syndrome: A Pilot Study. J Ultrasound Med. 2020 Sep;39(9):1759-68.
https://doi.org/10.1002/jum.15279
PMid:32255205
Hernández-Secorún M, Montaña-Cortés R, Hidalgo-García C, Rodríguez-Sanz J, Corral-de-Toro J, Monti-Ballano S, et al. Effectiveness of Conservative Treatment According to Severity and Systemic Disease in Carpal Tunnel Syndrome: A Systematic Review. Int J Environ Res Public Health. 2021 Feb 28;18(5):2365.
https://doi.org/10.3390/ijerph18052365
PMid:33671060 PMCid:PMC7957741
Klokkari D, Mamais I. Effectiveness of surgical versus conservative treatment for carpal tunnel syndrome: A systematic review, meta-analysis and qualitative analysis. Hong Kong Physiother J. 2018 Dec;38(02):91-114.
https://doi.org/10.1142/S1013702518500087
PMid:30930582 PMCid:PMC6405353
Chang KV, Wu WT, Özçakar L. Ultrasound imaging and guidance in peripheral nerve entrapment: hydrodissection highlighted. Pain Manag. 2020 Mar;10(2):97-106.
https://doi.org/10.2217/pmt-2019-0056
PMid:32162601
Mortada MA, Solyman A, Elsayed SB, Hassan MA. SAT0404 Efficacy and Safety of Hydrodissection of Median Nerve as a Treatment of Idiopathic Carpal Tunnel Syndrome. Ann Rheum Dis. 2013 Jun;72(Suppl 3):A719.4-A720.
https://doi.org/10.1136/annrheumdis-2013-eular.2128
Lam KHS, Wu YT, Reeves KD, Galluccio F, Allam AES, Peng PWH. Ultrasound-Guided Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analyses. Diagn Basel Switz. 2023 Mar 16;13(6):1138.
https://doi.org/10.3390/diagnostics13061138
PMid:36980446 PMCid:PMC10046938
Sveva V, Farì G, Fai A, Savina A, Viva MG, Agostini F, et al. Safety and Efficacy of Ultrasound-Guided Perineural Hydrodissection as a Minimally Invasive Treatment in Carpal Tunnel Syndrome: A Systematic Review. J Pers Med. 2024 Jan 30;14(2):154.
https://doi.org/10.3390/jpm14020154
PMid:38392587 PMCid:PMC10890373
Aboonq MS. Pathophysiology of carpal tunnel syndrome. Neurosci J. 2015 Jan 1;20(1):04-9.
Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016 Nov;15(12):1273-84.
https://doi.org/10.1016/S1474-4422(16)30231-9
PMid:27751557
CTS Associated or Caused by Other Medical Conditions. In: Carpal Tunnel Syndrome and Related Median Neuropathies. Cham: Springer International Publishing; 2017. p. 51-7.
https://doi.org/10.1007/978-3-319-57010-5_6
Carpal Tunnel Syndrome. In: Textbook of Natural Medicine [Internet]. Amsterdam: Elsevier; 2013 [cited 2024 Sep 17]. p. 1277-80. Available from: https://linkinghub.elsevier.com/retrieve/pii/B9781437723335001541
https://doi.org/10.1016/B978-1-4377-2333-5.00154-1
Hansen RL, Søndergaard M, Lange J. Open Surgery Versus Ultrasound-Guided Corticosteroid Injection for Trigger Finger: A Randomized Controlled Trial With 1-Year Follow-up. J Hand Surg. 2017 May;42(5):359-66.
https://doi.org/10.1016/j.jhsa.2017.02.011
PMid:28341069
Wang JC, Hsu PC, Wang KA, Chang KV. Ultrasound-guided triamcinolone acetonide hydrodissection for carpal tunnel syndrome: a randomized controlled trial. Frontiers in medicine. 2021 Sep 13;8:742724.
https://doi.org/10.3389/fmed.2021.742724
PMid:34589506 PMCid:PMC8475784
Wu YT, Li TY, Chen SR. Efficacy of ultrasound-guided corticosteroid injection for carpal tunnel syndrome: a randomized controlled trial. J Pain Res. 2022;15:1234-45.
Chen SR, Li TY, Wu YT. Effectiveness of ultrasound-guided platelet-rich plasma injection for carpal tunnel syndrome: a double-blind randomized controlled trial. J Clin Med. 2020;9(3):726.
Evers S, Bryan AJ, Sanders TL, Selles RW, Gelfman R, Amadio PC. Effectiveness of Ultrasound-Guided Compared to Blind Steroid Injections in the Treatment of Carpal Tunnel Syndrome. Arthritis Care Res. 2017 Jul;69(7):1060-5.
https://doi.org/10.1002/acr.23108
PMid:27696773 PMCid:PMC5376367
Chao TC, Reeves KD, Lam KHS, Li TY, Wu YT. The Effectiveness of Hydrodissection with 5% Dextrose for Persistent and Recurrent Carpal Tunnel Syndrome: A Retrospective Study. J Clin Med. 2022 Jun 27;11(13):3705.
https://doi.org/10.3390/jcm11133705
PMid:35806998 PMCid:PMC9267718
Mathieu T, Lemmens E, Stassijns G. A safe and easy-to-use ultrasound-guided hydrodissection technique for the carpal tunnel syndrome: a minimally invasive approach. J Ultrasound. 2021 Jul 2;25(3):451-5.
https://doi.org/10.1007/s40477-021-00597-5
PMid:34213741 PMCid:PMC9402831
Nakamichi K ichi, Tachibana S, Yamamoto S, Ida M. Percutaneous Carpal Tunnel Release Compared With Mini-Open Release Using Ultrasonographic Guidance for Both Techniques. J Hand Surg. 2010 Mar;35(3):437-45.
https://doi.org/10.1016/j.jhsa.2009.12.016
PMid:20193860
Li TY, Chen SR, Shen YP, Chang CY, Su YC, Chen LC, et al. Long-term outcome after perineural injection with 5% dextrose for carpal tunnel syndrome: a retrospective follow-up study. Rheumatol Oxf Engl. 2021 Feb 1;60(2):881-7.
https://doi.org/10.1093/rheumatology/keaa361
PMid:32856082
Chen SR, Ho TY, Shen YP, Li TY, Su YC, Lam KHS, et al. Comparison of short- and long-axis nerve hydrodissection for carpal tunnel syndrome: A prospective randomized, single-blind trial. Int J Med Sci. 2021;18(15):3488-97.
https://doi.org/10.7150/ijms.63815
PMid:34522175 PMCid:PMC8436111
Elawamy A, Mokbel E, Abdallah S. Hydrodissection with dextrose for carpal tunnel syndrome: a randomized controlled trial. J Anesth. 2020;34(1):32-8.
Michalik J, Wolski D, Bieńko M, Radzki R, Wolska M. Life quality of patients with the carpal tunnel syndrome. Eur J Clin Exp Med. 2018;16(3):217-23.
https://doi.org/10.15584/ejcem.2018.3.7
Lins L, Carvalho FM. SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Med. 2016 Jan 1;4:2050312116671725.
https://doi.org/10.1177/2050312116671725
PMid:27757230 PMCid:PMC5052926
Huang CY, Lai CY, Reeves KD, Lam KHS, Li TY, Cheng CI, et al. Volume Effect of Nerve Hydrodissection for Carpal Tunnel Syndrome. J Ultrasound Med. 2024;43(1):161-9.
https://doi.org/10.1002/jum.16349
PMid:37873682
Chen CH, Jaw FS, Hu JZ, Wu WT, Chang KV. Dynamic ultrasound for evaluating the adequacy of median nerve decompression following minimally invasive carpal tunnel release: technical innovation and case study. Heliyon. 2023;9(1):e13107.
https://doi.org/10.1016/j.heliyon.2023.e13107
PMid:36711298 PMCid:PMC9880394
Joshi HP, Jo HJ, Kim YH, An SB, Park CK, Han I. Stem Cell Therapy for Modulating Neuroinflammation in Neuropathic Pain. Int J Mol Sci. 2021 Jan;22(9):4853.
https://doi.org/10.3390/ijms22094853
PMid:34063721 PMCid:PMC8124149
Zakeri H, Radmehr M, Khademi F, Pedramfard P, Montazeri L, Ghanaatpisheh M, et al. Utilizing Artificial Intelligence for the Diagnosis, Assessment, and Management of Chronic Pain. J biomed phys eng. 2023; (): -.
Covotta M, Claroni C, Costantini M, Torregiani G, Pelagalli L, Zinilli A, et al. The Effects of Ultrasound-Guided Transversus Abdominis Plane Block on Acute and Chronic Postsurgical Pain After Robotic Partial Nephrectomy: A Prospective Randomized Clinical Trial. Pain Med. 2020 Feb 1;21(2):378-86.
https://doi.org/10.1093/pm/pnz214
PMid:31504875
Margalit A, Phalen H, Gao C, Ma J, Suresh KV, Jain P, et al. Autonomous Spinal Robotic System for Transforaminal Lumbar Epidural Injections: A Proof of Concept of Study. Glob Spine J. 2024 Jan 1;14(1):138-45.
https://doi.org/10.1177/21925682221096625
PMid:35467447 PMCid:PMC10676186
Gesslbauer C, Mickel M, Schuhfried O, Huber D, Keilani M, Crevenna R. Effectiveness of focused extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome: A randomized, placebo-controlled pilot study. Wien Klin Wochenschr. 2021 Jun;133(11-12):568-77.
https://doi.org/10.1007/s00508-020-01785-9
PMid:33351153 PMCid:PMC7754699
Li W, Dong C, Wei H, Xiong Z, Zhang L, Zhou J, et al. Extracorporeal shock wave therapy versus local corticosteroid injection for the treatment of carpal tunnel syndrome: a meta-analysis. J Orthop Surg. 2020 Nov 23;15(1):556.
https://doi.org/10.1186/s13018-020-02082-x
PMid:33228746 PMCid:PMC7685634

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