Ultrasonic waveguide guided minimally invasive surgery bids farewell to hand numbness and pain

        Wrist tunnel syndrome is an occupational disease commonly found in workers with repetitive hand or wrist movements, including housewives who frequently use both hands for labor, laborers, delivery drivers who ride motorcycles all day, or office workers who use keyboards and mice for long periods of time, all of whom are high-risk groups. Common symptoms include numbness and pain in the fingers and palms, as well as inability to write with a pen, twist towels, open bottle caps, grip motorcycle handles, and in severe cases, difficulty falling asleep due to numbness in the hands. This issue of the 'Health Column' introduces the causes and treatment methods of this condition, reminding people who are troubled by it not to ignore the health warnings.

                Causes of carpal tunnel syndrome

        The causes of carpal tunnel syndrome are mostly due to overuse, inflammation, injury, hormonal changes in the wrist area, or congenital constitution leading to hyperplasia and hypertrophy, causing the "median nerve" that controls the fingers and palms to be compressed for a long time from the root of the palm to the wrist (carpal tunnel), resulting in abnormal nerve reactions. During diagnosis, the "Phalen test" can be performed by squeezing the wrist or the "Tinel sign" can be performed by tapping the median nerve of the wrist. If there is atrophy of the large fish border muscle at the base of the thumb, it is a sign of median nerve compression.

        Physicians usually arrange further nerve conduction tests in outpatient clinics to confirm whether there are any significant abnormalities in the transmission of electrical signals through the wrist. If the patient has cervical degeneration or bone spurs, the nerve pathway from the fingers to the brain may also be subjected to double compression, requiring differential diagnosis by a physician, and sometimes additional cervical spine related examinations may need to be arranged.

        Treatment of carpal tunnel syndrome

        The treatment of carpal tunnel syndrome can be divided into "conservative treatment" and "median nerve decompression surgery".

        1. Conservative treatment

        Try to minimize the use of hand work, receive pain relief or steroid medication treatment, rehabilitation treatment, or wear wrist tunnel syndrome specific hand support plates. In addition, ultrasound assisted injection of glucose solution or steroid drugs around the nerves can also alleviate pain in some patients.

        2. Ultrasound assisted median nerve decompression surgery

        For patients with severe symptoms that affect their quality of life, surgery is an option that can quickly alleviate the symptoms. As long as the ligaments that restrict the wrist tunnel are cut open and the pressure on the median nerve is released, the symptoms of fingers and palms can be alleviated. Traditional surgery involves cutting a 1.5-2cm incision at the base of the palm, incising the ligament up to the nerve, and then cutting the subcutaneous ligament along the nerve. Although the wound is not large, frequent daily activities of the palm and easy contact with water can lead to slow wound healing or time-consuming and laborious care. In addition, due to the well-developed peripheral nerves of the palm skin, pain near the wound may cause inconvenience to patients.

        With the popularization and advancement of ultrasound equipment, it has recently been commonly used to assist in the diagnosis and treatment of various joint, muscle, and peripheral nerve diseases. "Median nerve decompression surgery" uses ultrasound assisted, combined with a special minimally invasive barb blade, to reduce the wound to 0.2~0.3 cm, which not only reduces the difficulty of wound care and faster healing, but also does not affect the effect of surgery because of the small wound. In addition, during the surgery, ultrasound can help identify the blood vessels and nerves near the ligament, and improve the accuracy and safety of surgery; After ligament resection, ultrasound can also be used to evaluate whether the tendons and nerves in the wrist tunnel release pressure.

        The ultra minimally invasive surgery for ultrasonic guided carpal tunnel syndrome can effectively solve patients' hand pain problems and restore activity function. However, due to the possibility of nerve damage caused by long-term compression, even if postoperative pressure is relieved, some patients' paralysis or pain symptoms may not be completely relieved. It is recommended that the public seek medical attention as soon as possible if they experience symptoms of carpal tunnel syndrome. In addition, due to the partial incision of ligaments in the patient's palm during surgery, the grip strength may slightly weaken after surgery and gradually recover after about two months.

        summarize

        Although carpal tunnel syndrome is a common minor ailment, if left untreated, it may lead to prolonged nerve compression and permanent damage. Therefore, if you frequently experience numbness or pain in your fingers or palms, please feel free to seek further consultation and evaluation at Far Eastern Memorial Hospital Neurosurgery Department.

        Dr. Li Jianxun's expertise includes: minimally invasive surgery for carpal tunnel syndrome with ultrasonic guidance, head and spine trauma and critical care, hemorrhagic stroke, senile hydrocephalus, and spine degenerative diseases (such as spine slippage, bone spurs, and disc herniation).

                #