Comparison of pulsed radiofrequency and steroid injection in the treatment of carpal tunnel syndrome guided by USG imaging

Abstract

Aims: The research evaluated the effectiveness between ultrasonography-guided pulsed radiofrequency treatment and steroid injection therapy for carpal tunnel syndrome. Methods: The research included 60 patients who received carpal tunnel syndrome diagnoses. The patients received their treatment based on two distinct approaches which formed separate groups: 30 patients who underwent ultrasonography-guided injection of 40 mg methylprednisolone acetate and 30 patients who underwent ultrasonography-guided application of pulsed radiofrequency targeting the median nerve at 42°C for 120 seconds. Visual Analog Scale (VAS) score, Boston Carpal Tunnel Scale and physical examination findings were evaluated before treatment, at 1, 3 and 6 months. All patients underwent EMG before the procedure and at 6 months. Results: At baseline, no significant variations were observed across groups regarding demographic characteristics as well as clinical parameters. At the third month, the VAS score decreased to 2.9±1.5 in the RF group while it was still 3.8±2.1 in the steroid group (p=0.048). Functional scores of the Boston scale were 1.6±0.7 in the pulsed radiofrequency group and 2.0±0.8 in the steroid group (p=0.037). In the electrophysiologic evaluation at the sixth month, motor distal latency was 3.9±0.7 ms in the RF group versus 4.3±0.8 ms in the steroid group (p=0.041). The rate of more than 50% improvement in VAS score was 80% in the RF group compared to 60% in the steroid group. Conclusion: Pulsed radiofrequency therapy delivers superior long-term results than steroid injection does. As a minimally invasive method, it should be evaluated before surgery.

Keywords

• Carpal tunnel syndrome
• median nerve
• pulsed radiofrequency treatment
• corticosteroid injection
• ultrasonography

USG görüntüleme rehberliğinde karpal tünel sendromu tedavisinde pulsed radyofrekans ile steroid enjeksiyonunun karşılaştırılması

Abstract

Amaç: Karpal tünel sendromunun tedavisinde ultrasonografi kılavuzluğunda pulsed radyofrekans ve steroid enjeksiyonunun etkinliğini karşılaştırmak amaçlandı. Yöntem: Bu retrospektif çalışmaya karpal tünel sendromu tanısı alan 60 hasta dahil edildi. Hastalar tedavi yöntemine göre iki gruba ayrıldı: 30 hastaya ultrasonografi kılavuzluğunda 40 mg metilprednizolon asetat enjeksiyonu, 30 hastaya ise ultrasonografi kılavuzluğunda 42°C'de 120 saniye süreyle median sinire pulsed radyofrekans uygulandı. VAS skoru, Boston Karpal Tünel Ölçeği, fizik muayene bulguları ve elektrofizyolojik parametreler tedavi öncesi, 1, 3 ve 6. aylarda değerlendirildi. Sonuçlar: Başlangıçta, gruplar arasında demografik özellikler ve klinik parametreler açısından fark yoktu. Üçüncü ayda, VAS skoru pulsed radyofrekans grubunda 2,9±1,5'e düşerken, steroid grubunda 3,8±2,1 olarak kaldı (p=0,048). Boston ölçeğinin fonksiyonel skorları pulsed radyofrekans grubunda 1,6±0,7, steroid grubunda 2,0±0,8 idi (p=0,037). Altıncı ayda yapılan elektrofizyolojik değerlendirmede, motor distal latensi pulsed radyofrekans grubunda 3,9±0,7 ms ve steroid grubunda 4,3±0,8 ms idi (p=0,041). VAS skorunda %50'den fazla iyileşme oranı pulsed radyofrekans grubunda %80 ve steroid grubunda %60 idi. Sonuç: Pulsed radyofrekans tedavisi, steroid enjeksiyonuna göre uzun vadede daha üstün sonuçlar vermektedir. Minimal invaziv bir yöntem olarak, cerrahi öncesi değerlendirilmelidir.

Keywords

• Karpal Tünel Sendromu
• Median Sinir
• Pulsed Radyofrekans Tedavisi
• Ultrasonografi

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