Open vs retractor-endoscopic in situ decompression of the ulnar nerve in cubital tunnel syndrome: a retrospective cohort study

Neurosurgery. 2013 Apr;72(4):605-16; discussion 614-6. doi: 10.1227/NEU.0b013e3182846dbd.

Abstract

Background: Both open ulnar nerve decompression and retractor-endoscopic ulnar nerve decompression have been shown to yield good results. However, a comparative evaluation of the techniques is lacking.

Objective: To compare the results of open and endoscopic surgery in cubital tunnel syndrome.

Methods: One hundred fourteen patients undergoing open (n = 59) or endoscopic (n = 55) decompression of the ulnar nerve for cubital tunnel syndrome were retrospectively compared. The long- and short-term outcomes were compared with respect to the time until return to full activity and the duration of postoperative pain. Additionally, matched pairs between the 2 groups were chosen for analysis (n = 34).

Results: Long-term results in the open vs endoscopic groups were as follows: excellent results, 54.2% vs 56.4%; good results, 23.8% vs 32.7%; fair results, 20.3% vs 9.1%; and poor results, 1.7% vs 1.8%, respectively. For the matched pairs, the results had similar significance levels (P = .84). The times until return to full activity in the open vs the endoscopic groups were as follows: 2 to 7 days, 18.6% vs 76.4%; 7 to 14 days, 55.9% vs 10.9%; and > 14 days, 25.4% vs 12.7% (P < .001 between nonmatched and matched pairs). The durations of postoperative pain in the open vs the endoscopic groups were as follows: 1 to 3 days, 45.8% vs 67.3%; 3 to 10 days, 42.5% vs 25.4%; and > 10 days, 11.7% vs 7.3% (P =.04 for nonmatched and P = .05 for matched pairs).

Conclusion: There are no significant differences in long-term outcomes after open and retractor-endoscopic in situ decompression of the ulnar nerve in cubital tunnel syndrome. The short-term results are significantly better in endoscopic surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Cubital Tunnel Syndrome / diagnosis*
  • Cubital Tunnel Syndrome / epidemiology
  • Cubital Tunnel Syndrome / surgery*
  • Decompression, Surgical / adverse effects
  • Decompression, Surgical / instrumentation
  • Decompression, Surgical / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neuroendoscopy / adverse effects
  • Neuroendoscopy / instrumentation
  • Neuroendoscopy / methods*
  • Pain, Postoperative / diagnosis*
  • Pain, Postoperative / epidemiology
  • Retrospective Studies
  • Treatment Outcome
  • Ulnar Nerve / pathology
  • Ulnar Nerve / surgery*
  • Young Adult