The Effect of Preoperative B12 Level on Recovery in Patients with Moderate CTS Who Underwent Surgery

Öz

Objective: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, resulting from compression of the median nerve in the wrist. Vitamin B12 deficiency is associated with hematological, gastrointestinal, and neuropsychiatric disorders, and may contribute to neurological symptoms through impaired neuronal myelination. This study investigates the effect of preoperative B12 levels on postoperative recovery in patients undergoing surgery for moderate CTS. Materials and Methods: Our study involved 47 patients undergoing CTS surgery in whom preoperative B12 levels were investigated. Clinical findings were retrospectively analyzed. Symptom severity and functional status were evaluated using validated scales: the Boston Symptom Severity Scale (SSS), Boston Functional Status Scale (FSS), and the Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) questionnaire. These scores were recorded preoperatively and at months 3,6 and 12. postoperatively. Patients were categorized into two groups: Group 1 (B12 > 300 ng/L) and Group 2 (B12 < 300 ng/L). Appropriate statistical analyses (Kolmogorov-Smirnov, Mann-Whitney U, Student’s t-test) were applied. Results: The mean age of patients was 50.96±11.06 years. There were 32 patients in Group 1 and 15 in Group 2. No significant differences were found between groups in age (P=0.501), gender (P=0.168), or preoperative questionnaire scores (SSS: P=0.429; FSS: P=0.376; Quick-DASH: P=0.871). However, at the 3-month postoperative follow-up, a statistically significant improvement was observed in Group 1, and this improvement persisted through the 12-month follow-up. Conclusion: Our findings suggest that evaluating and correcting B12 levels prior to surgery may enhance postoperative recovery in patients with moderate CTS.

Anahtar Kelimeler

• Vitamin B12
• CTS
• recovery
• surgery
• treatment.

Cerrahi Olarak Tedavi Edilen KTS Hastalarında Preop B12 Düzeyinin İyileşmeye Etkisi

Abstract

Amaç: Karpal tünel sendromu (KTS), el bileği düzeyinde median sinirin sıkışması sonucu oluşan ve en sık görülen sıkışma nöropatisidir. B12 eksikliği hematolojik, gastrointestinal ve nöropsikiyatrik bozukluklara neden olabilir ve kesin olmamakla birlikte nöronal miyelinleşmedeki sorunlardan dolayı nörolojik semptomların ortaya çıkabileceği düşünülmektedir. Gereç ve Yöntemler: Çalışmamızda karpal tünel sendromu ameliyatı geçiren 47 hastanın ameliyat öncesi B12 düzeylerini araştırdık. Hastaların klinik bulguları retrospektif olarak analiz edildi. Hastaların ameliyat öncesi B12 düzeyleri ile birlikte Bostan Quick Disability of the Arm, Shoulder, and Hand (Quick DASH) anketinin ameliyat öncesi ve sonrası değerleri değerlendirildi. KTS'li hastalarda semptomların şiddeti ve fonksiyonel durum, Boston anketindeki semptom şiddeti ölçeği (SSS) kullanılarak değerlendirildi. SSS semptomları şiddetine, sıklığına, zamanına ve türüne göre değerlendirir. Her iki anketin değerleri ameliyat sonrası 3., 6. ve 12. aylarda kaydedildi. Bulgular: Çalışmamıza dahil edilen hastaların yaş ortalaması 50,96±11,06 idi. Gruplar 300'lük bir kesme değerinin üstünde veya altında olarak sınıflandırıldı. Gruplar arasında yaş (P=0,501) veya cinsiyet (P=0,168) açısından anlamlı bir fark bulunmamıştır. Ayrıca gruplar arasında ameliyat öncesi Boston şiddet ölçeği ve Boston fonksiyonel ölçeğinde anlamlı bir fark yoktu (sırasıyla P=0,429 ve P=0,376). Ancak ameliyat sonrası 3. ay takibinde B12 düzeyi yüksek olan grupta anlamlı düzelme görüldü ve bu düzelme 12. ay takibinde de devam etti. Sonuç: Çalışmamızda, cerrahi planlanan hastalarda B12 düzeylerinin değerlendirilip yerine konulmasının yararlı olabileceğini düşündük. Cerrahi uygulanan ve preoperatif B12 düzeyleri yüksek olan orta şiddette KTS'li hastalarda daha belirgin iyileşme gözlemledik.

Keywords

• Vitamin B12
• CTS
• recovery
• surgery
• treatment.

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