Carpal tunnel syndrome (CTS) is the most common nerve compression disorder of the upper extremities and among the most common peripheral neuropathies. CTS’ classic symptoms include pain associated with numbness and tingling in the distribution of the median nerve in the hand.
Patients with mild CTS symptoms can be managed with conservative treatments. For more severe symptoms or when conservative treatments fail, cure is possible only with surgery, which aims to relieve pressure on the median nerve by dividing the transverse carpal ligament. Endoscopic and open surgery are both effective, but optimal outcomes depend on using the approach that is most appropriate and least likely to require additional surgery in the future.
Endoscopic approach.
With a 1 cm incision in a wrist crease and a small stab wound just beyond the ligament, this approach is less invasive than open surgery, and patients often resume normal activities a week or two earlier. The endoscopic procedure does require general anesthesia, which some patients want to avoid. Also, inability to actually see the nerve can lead to incomplete sectioning. However, neurosurgeon E. Thomas Cullom, MD, has found that, all factors being equal, endoscopy usually results in less pain and faster return to normal function.
Open technique.
Performed using local anesthesia, the traditional open surgical approach is often preferred by patients who don’t want general anesthesia. Also, because it allows direct visualization, open carpal tunnel surgery is usually more successful for patients who have very large hands, extensive arthritis, previous CTS surgery or fibrous material adhering to the median nerve. Yet, patients who have had both surgical approaches report that the open surgery results in greater pain and a much slower return to regular activities.
Give patients experienced care, appropriate treatment & effective relief.
An experienced and board-certified neurosurgeon, Dr. Cullom has performed surgical release of CTS on many patients, including those with bilateral injury. His experience and advanced competency with both procedures ensures patients receive the most appropriate and effective treatment. In addition, Dr. Cullom can recognize and treat cervical radiculopathy, which often obscures a CTS diagnosis and is also frequently present in patients with CTS.
Please visit our interactive Patient Education Library to learn more about carpal tunnel syndrome.
Your referrals and inquiries regarding carpal tunnel syndrome — or any other neurosurgery subject — are welcome and encouraged. Call Comprehensive Neurosurgery in Flowood at 601-664-1000. We are conveniently located just outside of Jackson and Forest, Mississippi.