Year: 2025 | Month: December | Volume: 12 | Issue: 12 | Pages: 10-19
DOI: https://doi.org/10.52403/ijrr.20251202
Neurolysis in Carpal Tunnel Release for Carpal Tunnel Syndrome Patients
Made Bramantya Karna1, I Made Bagus Surya Mahapriandana Sari2
1Orthopaedic Surgeon, Dept. Orthopaedic & Traumatology, Prof IGNG Ngoerah General Hospital, Udayana University, Bali, Indonesia
2Resident, Dept. Orthopaedic & Traumatology, Prof IGNG Ngoerah General Hospital, Udayana University, Bali, Indonesia
Corresponding Author: I Made Bagus Surya Mahapriandana Sari
ABSTRACT
Background: After Open Carpal Tunnel Release (OCTR), up to 20% of patients experience persistent or recurrent symptoms, necessitating revision procedures. External neurolysis has emerged as a promising adjunct to OCTR, particularly in patients with adhesions or recurrent CTS. This study aims to systematically evaluate the functional outcomes and complications associated with Carpal Tunnel Release combined with neurolysis in CTS patients.
Methods: A systematic review was conducted following PRISMA 2020 guidelines and Cochrane Handbook standards. Literature was searched from 2019 to June 2024 across MEDLINE (PubMed), Embase (Ovid), CENTRAL, and Web of Science. Inclusion criteria encompassed clinical studies evaluating OCTR with neurolysis in CTS patients, focusing on functional outcomes and complications. A total of four studies involving 114 patients were included. Risk of bias was assessed using ROBINS-I and JBI tools.
Results: Of the four studies, one was cross-sectional and three were case series. Functional outcomes were measured using BCTQ-SS, BCTQ-FS, DASH, QuickDASH, VAS, grip strength, and distal motor latency. Across studies, OCTR with external neurolysis showed consistent improvements in symptom severity, functional status, pain reduction, and nerve conduction parameters. No major complications were reported. However, all included studies presented moderate to high risk of bias due to non-randomized designs and small sample sizes.
Conclusion: OCTR with external neurolysis shows promising functional improvement in patients with CTS, particularly in cases of persistent or recurrent symptoms. Nevertheless, due to methodological limitations and small sample sizes, higher-quality studies such as randomized controlled trials are warranted to confirm these findings.
Keywords: Carpal Tunnel Syndrome, Open Carpal Tunnel Release, Neurolysis, External Neurolysis, Functional Outcome, Systematic Review, Recurrent CTS, BCTQ, DASH, Visual Analog Scale.
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