Hydrodissection for Carpal Tunnel Syndrome

@article{Neo2021HydrodissectionFC,
  title={Hydrodissection for Carpal Tunnel Syndrome},
  author={Edmund Jin Rui Neo and Nine Shan and San San Tay},
  journal={American Journal of Physical Medicine \& Rehabilitation},
  year={2021},
  volume={101},
  pages={530 - 539}
}
Abstract Hydrodissection is an ultrasound-guided technique that has received more attention recently for its role in nerve entrapment syndromes. The purposes of this systematic review were to evaluate the safety and effectiveness of hydrodissection in carpal tunnel syndrome and to investigate the ideal parameters for injectate type, dosage, volume, and frequency; injection approach and technique; as well as operator experience and training required. We searched the Embase, MEDLINE, and PubMed… 

References

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TLDR
Compared with the control group, the intervention group showed significantly greater improvement at the second and third posttreatment months according to BCTQ severity score and at all time‐points for cross‐sectional area of the median nerve.
Hydrodissection for treatment of carpal tunnel syndrome
In this issue, Evers et al. demonstrate that, in a cadaver preparation, infiltration of saline into the carpal tunnel can reduce the resistance to longitudinal sliding of the median nerve. This
Ultrasound-guided Hydrodissection for Severe Carpal Tunnel Treatment
TLDR
Ultrasound-guided hydrodissection and corticosteroid injection of the carpal tunnel seems an effective treatment for severe carpal Tunnel syndrome in the short-term, with a success rate estimated at 56% of the patients.
Efficacy of Hyalase Hydrodissection in the Treatment of Carpal Tunnel Syndrome: A Randomized, Double-Blind, Controlled, Clinical Trial.
TLDR
Cpal tunnel HD with Hyalase with saline solution is considered as an efficient technique offering a rapid onset of pain relief and functional improvements, and better median nerve conduction in patients with CTS over 6 months follow-up duration.
Ultrasound-Guided Hydrodissection With Corticosteroid Injection in the Treatment of Carpal Tunnel Syndrome: A Pilot Study.
TLDR
After injection, both symptomatic and functional scores improved, but the hydrodissected group did not show additional improvement, and data presented can be used to support larger studies to assess the value of hydrodissection in CTS management.
Median Nerve Injury in Ultrasound-Guided Hydrodissection and Corticosteroid Injections for Carpal Tunnel Syndrome.
TLDR
MNI during hydrodissection may be reversible and is indicated by an increase in MN-CSA-inlet immediately after hydro Dissection, which is unrelated to prolonged transient MNI.
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TLDR
Local corticosteroid injection for carpal tunnel syndrome provides greater clinical improvement in symptoms one month after injection compared to placebo and provides significantly greaterclinical improvement compared to oral steroid up to three months after treatment.
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TLDR
Corticosteroid injections for CTS provided by general practitioners are effective regarding short-term outcomes when compared to placebo injections, and the short- term beneficial treatment effects of steroid injections deteriorated during the follow-up period of twelve months and half of the cohort of steroid-responders had recurrences.
Dexamethasone versus Hyaluronidase as an Adjuvant to Local Anesthetics in the Ultrasound-guided Hydrodissection of the Median Nerve for the Treatment of Carpal Tunnel Syndrome Patients
TLDR
This study was carried out to compare the efficacy of hyaluronidase versus dexamethasone as adjuvants to the mixture of LAs in ultrasound (US)-guided hydrodissection of the median nerve in mild to moderate cases of carpal tunnel syndrome.
Ultrasound-Guided Nerve Hydrodissection for Pain Management: Rationale, Methods, Current Literature, and Theoretical Mechanisms
TLDR
Authors suggest five percent dextrose may be favored as the preferred injectate based on preliminary comparative-injectate literature, but additional research is critical for a direct ameliorative effect on neuropathic pain.
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