Is there a relationship between impaired median nerve excursion and carpal tunnel syndrome? A systematic review

Abstract

Study design: Systematic review.

Introduction: It is accepted that the etiology of carpal tunnel syndrome (CTS) is multifactorial. One of the most commonly accepted etiologic factors for CTS is compromise of the kinematic behavior and excursion of the median nerve.

Purpose of the study: The objective of this systematic review was to establish if there is a relationship between impaired median nerve excursion and CTS.

Methods: A systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, was conducted. Studies were sought where in vivo median nerve excursion was compared between people with CTS to an appropriate control group. Quality appraisal for each study was conducted using the Newcastle-Ottawa Scale by 2 independent evaluators.

Results: Ten case-control studies using ultrasound imaging to quantify median nerve excursion were included. All studies were rated as of "moderate" methodologic quality having scored 6 or 7 (of 9 stars) for the Newcastle-Ottawa Scale. Seven of the 10 studies concluded that median nerve excursion was reduced in a CTS population when compared with controls.

Conclusion: The literature suggests that median nerve excursion is reduced in people with CTS when compared with healthy controls.

Level of evidence: 3a.

Keywords: Carpal tunnel syndrome; Median nerve; Systematic review; Ultrasound imaging.