ASPN - A Comparison of Retractor-Integrated Endoscopic and Open Ulnar Nerve Decompression Techniques In Cubital Tunnel Syndrome

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A Comparison of Retractor-Integrated Endoscopic and Open Ulnar Nerve Decompression Techniques In Cubital Tunnel Syndrome
Stephan D�tzmann; Daniel Martin, MD; Gerhardt Marquardt, MD, PhD; Gabriele Schackert, MD, PhD; Volker Seifert; Kartik Krishnan
University of Frankfurt Dept. of Neurosurgery, Frankfurt, Germany

Abstract Objective: Open in situ decompression of the ulnar nerve yields excellent predictable results, thus serves as a standart for comparison of other techniques. Endoscopic techniques have also been reported to produce good

Results: A comparative analysis between the two techniques is lacking in the literature. Our aim is to compare the results of the endoscopic and the open techniques in ulnar nerve decompression surgery.

Methods: This is a retrospective study. We analyzed the data of 184 patients (110 males, 74 females; mean age 50 years) with cubital tunnel syndrome that were operated in our institutions during a ten-year period. Patients were divied into 3 Groups: 75 patients underwent open in situ decompression of the ulnar nerve (Group A); 47 had endoscopic in situ decompression (Group B) and 62 had endoscopic anterior subcutaneous transposition (Group C). The samples were chosen according to the McGowan grading system to plausibly match with each other. The postoperative outcome was assessed by clinical follow-up examinations performed 6 months after surgery using the Bishop score and a structured telephone interview in 2010. The mean follow-up was 53.8 months (range: 24-96 months).

Results: Preoperative McGowan grades and duration of symptoms were distributed equally in the groups. Postoperative Bishop scores did not differ significantly between the three groups. Occupational usage of the hand returned to normal levels in 90% of the open surgical group, 75% in the endoscopic transpositional group and 85% in the endoscopic in situ decompression group(p=0.131). Time to return of full function was significantly shorter in both endoscopic groups (p

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