The application of ultrasound-guided percutaneous transforaminal endoscopy in treating carpal tunnel syndrome

This is a prospective cohort study. The purpose of this study is to evaluate the clinical outcomes of ultrasound-guided percutaneous transforaminal endoscopy in the treatment of CTS. Currently, the primary surgical approaches for carpal tunnel syndrome (CTS) are open release and endoscopic surgery, each with distinct advantages and limitations. The ultrasound-guided percutaneous transforaminal endoscopy is a modified endoscopic minimally invasive treatment for CTS. A total of 36 CTS patients (39 wrists) were collected From January 2021 to June 2024 in the study. Ultrasound was employed to locate the transverse carpal ligament and median nerve, followed by carpal tunnel release using the transforaminal endoscopic system. Hand symptoms and function were assessed at 2 weeks, 1 month, 3 months and 6 months postoperatively using the Boston Carpal Tunnel Questionnaire-Symptom Severity Score (BCTQ-S) and the Boston Carpal Tunnel Questionnaire-Function Status Scale (BCTQ-F). Preoperative and 6-month postoperative median nerve cross-sectional area (CSA) and flattening ratio of the median nerve were measured with high-frequency ultrasound. And the occurrence of scar pain and postoperative complications were observed. At all follow-up points, both BCTQ-S and BCTQ-F scores were significantly lower than their preoperative values (P < 0.05). At the 6-month follow-up, the median nerve CSA and the flattening ratio demonstrated marked improvement (P < 0.05). No cases of nerve or vascular injury or incision infections were reported, and only 2 out of the 39 treated wrists developed painful scar. The combination of ultrasound guidance and transforaminal endoscopic release of the transverse carpal ligament has been proven to be an effective and safe treatment for CTS.