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

Authors

  • Ronza R Alsaffar Physiology Department, Tehran University for Medical Science, Tehran, Iran
  • Zeyad Tareq Kareem Alsadiq General Hospital, Babylon Governorate, Iraq
  • Farah N Abbas Physiology Department, Babylon University, College of Medicine, Babylon Governorate, Iraq

DOI:

https://doi.org/10.31661/gmj.v14i.3638

Keywords:

Carpal Tunnel Syndrome; Hydrodissection; Ultrasound-Guided Therapy; Median Nerve; Pain

Abstract

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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Published

2025-01-20

How to Cite

Alsaffar, R. R., Kareem, Z. T., & Abbas, F. N. (2025). 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. Galen Medical Journal, 14, e3638. https://doi.org/10.31661/gmj.v14i.3638

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Review Article