The incidence and decompression rates of median and ulnar neuropathies following shoulder surgery
© 2024 The Authors.
| Veröffentlicht in: | JSES international. - 2020. - 8(2024), 5 vom: 28. Sept., Seite 1110-1114 |
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| 1. Verfasser: | |
| Weitere Verfasser: | , , , , , , , |
| Format: | Online-Aufsatz |
| Sprache: | English |
| Veröffentlicht: |
2024
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| Zugriff auf das übergeordnete Werk: | JSES international |
| Schlagworte: | Journal Article Carpal tunnel syndrome Complications Cubital tunnel syndrome Peripheral neuropathy Shoulder surgery Surgical decompression |
| Zusammenfassung: | © 2024 The Authors. Background: Upper extremity peripheral neuropathy is a known, but uncommon complication that can occur after shoulder surgery. The incidence rate is well documented, and most of these cases historically have been treated conservatively. However, we hypothesize peripheral compression neuropathy requires a much higher need for surgical decompression than originally reported. The purpose of this study was to evaluate the incidence, decompression rates, and prognostic factors for developing median and ulnar neuropathies following shoulder surgery Methods: A retrospective chart review was performed examining patients who underwent open and arthroscopic shoulder surgery from a multisurgeon, single-institution database. Perioperative data and functional outcomes were recorded. Symptom resolution was assessed with both conservative and surgical management of compression peripheral neuropathy. Further analysis was made to compare open and arthroscopic procedures, the type of neuropathy developed, and electromyographic (EMG) severity Results: The incidence rates of compression peripheral neuropathy following open arthroplasty and arthroscopic procedures was 1.80% (31/1722) and 0.54% (44/8150), respectively. 73.33% (55/75) of patients developed ipsilateral disease, while 20.00% (15/75) of patients had bilateral disease. Amongst the 75 included patients, there were 99 cases of neuropathy. Carpal tunnel syndrome was more common than cubital tunnel syndrome, comprising 61.61% (61/99) cases of neuropathy. 12.00% (9/75) of patients developed both carpal tunnel syndrome and cubital tunnel syndrome. Four patients were lost to follow-up. Decompression surgery was performed for 36.84% (35/95) cases of neuropathy with >90% obtaining symptom resolution with surgery. 63.16% (60/95) cases of neuropathy were managed conservatively, 71.67% (43/60) of which had persistent symptoms. When comparing arthroscopic versus open procedures, patients who underwent open procedures were significantly older (68.62 vs. 49.78 years, P < .001) and developed peripheral neuropathy significantly faster after the index procedure (87.24 vs. 125.58 days, P = .008). EMG severity did not correlate with decompression rates or symptom resolution. There were no differences in the subgroup analyses between beach chair and lateral positioning in regard to the type of neuropathy, laterality of symptoms, and/or treatment received Conclusion: The overall incidence of peripheral neuropathy after shoulder surgery was 0.76% (75/9872). The development of peripheral neuropathy is multifactorial, with older patients undergoing open arthroplasty more at risk. Neuropathy symptoms were refractory to conservative management despite the type of shoulder surgery, type of neuropathy, or EMG severity. Decompression consistently led to resolution of symptoms |
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| Beschreibung: | Date Revised 17.09.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
| ISSN: | 2666-6383 |
| DOI: | 10.1016/j.jseint.2024.05.011 |