Pain and numbness one month after carpal tunnel release predict patient-reported outcome measures at sixth months

A number of outcome predictors for carpal tunnel release (CTR) for carpal tunnel syndrome (CTS) have been reported. However, some predictors are controversial, and few studies have referred to the early postoperative outcome prognostic factors after CTR. The aim of this study was to investigate whether pain and numbness at 1 month post-CTR were early postoperative predictors of clinical outcomes 6 months after surgery. Pain and numbness were evaluated using the visual analog scale (VAS) preoperatively and at 1 month post-surgery. Patient-reported outcome measures (PROMs), including the Quick Disabilities of the Arm, Shoulder and Hand (QDASH) measure, the Hand20 questionnaire and the Boston Carpal Tunnel Questionnaire (BCTQ), were recorded for each patient 6 months after surgery. The BCTQ consisted of the Symptom Severity Scale (SSS) and Functional Status Scale (FSS). Multivariable linear regression analysis was performed to investigate the association between the VAS scores and PROMs. We retrospectively identified 93 patients who underwent open carpal tunnel release (OCTR) or endoscopic carpal tunnel release. The mean age of the patients was 67.5 years, and 67 patients (72.0%) were female. Sixty patients were treated by OCTR (65.0%). With multivariable linear regression analysis, we found that pain and numbness, evaluated with VAS 1 month post-surgery had significant correlations with QDASH, Hand20, SSS and FSS 6 months after surgery. In conclusion, pain and numbness 1 month after CTR predict PROMs at 6 months.

目前已有多项针对腕管综合征（CTS）患者接受腕管松解术（CTR）的结局预测因子的研究报道。然而，部分预测因子尚存争议，且鲜有研究关注腕管松解术后早期的结局预后影响因素。本研究旨在探讨术后1个月时的疼痛与麻木症状，是否可作为术后6个月临床结局的早期术后预测因子。研究分别于术前及术后1个月采用视觉模拟评分法（VAS）对患者的疼痛与麻木症状进行评估。于术后6个月时，收集所有患者的患者报告结局指标（PROMs），包括上肢、肩和手功能快速障碍量表（QDASH）、Hand20问卷以及波士顿腕管问卷（BCTQ）。其中，波士顿腕管问卷包含症状严重度量表（SSS）与功能状态量表（FSS）。采用多变量线性回归分析，探究视觉模拟评分与患者报告结局指标之间的关联。本研究回顾性纳入93例接受开放式腕管松解术（OCTR）或内镜下腕管松解术的患者，患者平均年龄为67.5岁，其中女性67例，占比72.0%；60例患者接受开放式腕管松解术，占比65.0%。经多变量线性回归分析发现，术后1个月时通过视觉模拟评分评估的疼痛与麻木症状，与术后6个月时的上肢、肩和手功能快速障碍量表、Hand20问卷、症状严重度量表及功能状态量表得分均存在显著相关性。综上，腕管松解术后1个月的疼痛与麻木症状，可有效预测术后6个月的患者报告结局指标。