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Meta-Analysis
. 2020 Jan;15(1):13-22.
doi: 10.1177/1558944718787892. Epub 2018 Jul 17.

Comparison of the Short-Term and Long-Term Effects of Surgery and Nonsurgical Intervention in Treating Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis

Qiyun Shi  1   2 , Pavlos Bobos  1   2 , Emily A Lalone  1   2 , Laura Warren  3 , Joy C MacDermid  1   2   4
Affiliations
Meta-Analysis

Comparison of the Short-Term and Long-Term Effects of Surgery and Nonsurgical Intervention in Treating Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis

Qiyun Shi et al. Hand (N Y). 2020 Jan.

Abstract

Background: The objective of the study is to examine the short-term and long-term efficacy of surgical treatment of carpal tunnel syndrome (CTS) compared with conservative treatment (ie, splint, steroid injection, or physical therapy). Methods: Two reviewers searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and PEDro up to September 2017. Quality appraisal and data extraction were performed in duplicate. Patient self-reported functional and symptom changes, as well as improvement of electrophysiological studies, were assessed as outcomes. Meta-analyses were performed in RevMan. Results: From 1438 studies identified after searching, 10 remained for analysis after exclusion criteria were applied. Moderate-quality evidence indicated that surgical interventions were superior to splint or steroid injection at 6 months with a weighted mean difference of 0.25 (95% confidence interval [CI], 0.07-0.44) for functional status and 0.64 (95% CI, 0.07-1.21) for symptom severity. The surgical group had better nerve conduction outcomes at 6 months (0.57 [95% CI, 0.05-0.50] ms). No significant differences were observed at 3 or 12 months. Conclusions: Both surgical and conservative interventions provide treatment benefits in CTS. Further studies on long-term outcome are needed.

Keywords: carpal tunnel syndrome; conservative; efficacy; surgical treatment; systematic review and meta-analysis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Qiyun Shi, Pavlos Bobos, Emily A. Lalone, Laura Warren have no competing interest. Joy C. MacDermid holds The James Roth Research Chair in Musculoskeletal Health and CIHR Chair: Gender, Work and Health.

Figures

Figure 1.
Figure 1.
Schema of systematic review.
Figure 2.
Figure 2.
Patient self-reported functional severity. Note. CI = confidence interval.
Figure 3.
Figure 3.
Patient self-reported symptom severity. Note. CI = confidence interval.
Figure 4.
Figure 4.
Distal sensory latency improvement at 6 months.
See this image and copyright information in PMC

References

    1. American Academy of Orthopaedic Surgeons. Appropriate Use Criteria for the Management of Carpal Tunnel Syndrome. http://www.orthoguidelines.org/go/auc/auc.cfm?auc_id=224989. Published December 9, 2016. Accessed July 2, 2018.
    1. American Academy of Orthopaedic Surgeons. Management of Carpal Tunnel Syndrome Evidence-Based Clinical Practice Guideline. www.aaos.org/ctsguideline. Published February 29, 2016. Accessed July 2, 2018. - PubMed
    1. Atkins D, Eccles M, Flottorp S, et al. Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The GRADE Working Group. BMC Health Serv Res. 2004;4(1):38. - PMC - PubMed
    1. Awan AS, Khan A, Afridi SA, et al. Early response of local steroid injection versus mini incision technique in treatment of carpal tunnel. J Ayub Med Coll Abbottabad. 2015;27(1):192-196. - PubMed
    1. Bessette L, Sangha O, Kuntz KM, et al. Comparative responsiveness of generic versus disease-specific and weighted versus unweighted health status measures in carpal tunnel syndrome. Med Care. 1998;36(4):491-502. - PubMed