CARPAL TUNNEL RELEASE

What’s a Carpal Tunnel Release? 

The medical term “Carpal Tunnel Release” refers to a type of surgery that helps to treat a painful condition called carpal tunnel syndrome (Bland, 2007). Carpal tunnel syndrome (CTS) refers to a medical condition that occurs due to the compression of the median nerve that passes through the carpal tunnel in the wrist. Among various causes, the common causes of carpal tunnel syndrome include an overuse injury or a repetitive motion of wrist or hand while working. Other causes of carpal tunnel syndrome include fracture or sprain, or repetitive use of a vibrating tool. The risk factors of this condition comprise pregnancy, hereditary, diabetes, rheumatoid arthritis, obesity, and thyroid issues (Saint-Lary, Rébois, Mediouni, & Descatha, 2015). 

The carpal tunnel refers to a tiny canal in the wrist that houses the median nerve and tendons that allow the fingers to move. The wrist bones on the bottom and the transverse carpal ligament across the top (or inside) of the wrist form the carpal tunnel. Damaging this body part causes swelling of the tissues within the tunnel and pushes on the median nerve. If left untreated, this can result in numbness and tingling in the hand, as well as discomfort and loss of function. Symptoms normally present gradually and may worsen over time. The thumb side of the hand tends to sustain the most symptoms. A neurosurgeon cuts through the ligament, pulling down on the carpal tunnel during a carpal tunnel release. This allows the median nerve and tendons to travel through the tunnel with more room, which usually improves pain and function.

Risks of a Carpal Tunnel Release

Carpal tunnel release, similar to most operations, comes with risks. For the procedure, neurosurgeons numb the wrist by using local anesthetic agents to relieve pain. Some people possess the risk of general anesthesia. Besides these, a carpal tunnel release procedure may also carry some risks such as excessive bleeding, infections, damage of nerves, allergic reaction to medicines, weakness or numbness around the hand, or a sensitive scar (DeStefano, Nordstrom, & Vierkant, 1997). 

How should a patient prepare for a Carpal Tunnel Release?

Before the surgery, patients need to tell everything to their neurosurgeon regarding their medical history. Fort Worth Neurosurgeons suggest stopping taking blood thinning medicines such as aspirin, naproxen, and ibuprofen before the surgery. Also, neurosurgeons advise to avoid smoking before and after the operation, which can delay healing. Additionally, patients need to remain free from any other illness such as cold, flu, etc. before undergoing carpal tunnel release (Chung, 2006).

How does a Spinal Surgeon perform Carpal Tunnel Release?

Neurosurgeons classified carpal tunnel surgery into two categories. The classic procedure includes open release, in which the surgeon performs the surgery by cutting open the wrist. Another method includes endoscopic carpal tunnel release, which involves inserting a thin, flexible tube with a camera into the wrist through a small incision (cut). This camera guides the neurosurgeon to insert thin tools into the wrist through another minor cut. The general sequence of events in a carpal tunnel release surgery includes (Liawrungrueang & Wongsiri, 2020):

•   Neurosurgeons inject local anesthetic to numb the hand and wrist of the patient.
• Later, the neurosurgeon will make a 2-inch incision on the wrist during an open release procedure. The neurosurgeon next cuts the carpal ligament and enlarges the carpal tunnel with conventional surgical equipment.
• In endoscopic surgery, the neurosurgeon will make two half-inch incisions into the wrist and palm. Later, neurosurgeon will insert a camera with a narrow tube into one of the incisions. This camera will direct the neurosurgeon as he inserts the equipment and slices the carpal ligament through the other incision.
•     Finally, the neurosurgeon will close the incision of the skin and tissues with sutures.

How long does a Carpal Tunnel Release typically take? 

Usually, a carpal tunnel release surgery takes roughly 15 minutes. Patients, on the other hand, typically spend around 45 minutes in the operating room for equipment setup and administration of anesthesia. This outpatient procedure requires no need to stay at the hospital after operation. The patient’s wrist will most likely require a splint or heavy bandage for about a week after surgery. Patients need to keep this on until their first follow up appointment after the surgery, and make sure it stays clean and dry. Following the removal of the splint or bandage, the patient can start on motion exercises or a hand therapy program.

What does recovery from a Carpal Tunnel Release look like?

Carpal tunnel release relieves pain, numbness, and tingling while also restoring muscular strength. This operation helps the majority of patients. Carpal tunnel surgery takes time to heal–anywhere from a few weeks to several months. Recovery may take considerably longer for patients who squeeze their nerves for long periods of time. The recovery process includes splinting the wrist and receiving physical therapy to strengthen and mend the wrist and hand. Other dangers may exist, depending on the patient’s medical condition. Before the operation, patients should share their concerns with the neurosurgeon. For more information, please contact us.

References

Bland, J. D. P. (2007). Carpal tunnel syndrome. British Medical Journal, 335(7615), 343–346. https://doi.org/10.1136/bmj.39282.623553.AD

Chung, K. C. (2006). Current Status of Outcomes Research in Carpal Tunnel Surgery. Hand, 1(1), 9–13. https://doi.org/10.1007/s11552-006-0002-3

DeStefano, F., Nordstrom, D. L., & Vierkant, R. A. (1997). Long-term symptom outcomes of carpal tunnel syndrome and its treatment. Journal of Hand Surgery, 22(2), 200–210. https://doi.org/10.1016/S0363-5023(97)80152-9

Liawrungrueang, W., & Wongsiri, S. (2020). Effectiveness of Surgical Treatment in Carpal Tunnel Syndrome Mini-Incision Using MIS-CTS Kits: A Cadaveric Study. Advances in Orthopedics, 2020. https://doi.org/10.1155/2020/8278054

Saint-Lary, O., Rébois, A., Mediouni, Z., & Descatha, A. (2015). Carpal tunnel syndrome: Primary care and occupational factors. Frontiers in Medicine, 2(MAY), 1–4. https://doi.org/10.3389/fmed.2015.00028