Smit, J.A. (2019) Recurrent cubital tunnel syndrome is associated with age and spinal disc herniation. thesis, Medicine.
Full text available on request.Abstract
INTRODUCTION Ulnar nerve entrapment (UNE) is the second most common upper extremity compression neuropathy, with carpal tunnel syndrome being the first. Although risk factors are known for primary surgery (e.g. prior fractures, diabetes, space-occupying lesions), only one study focused on risk factors for revision surgery. The aim of this study is to investigate specific potential risk factors for recurrent surgery. METHODS A retrospective cohort study was performed by using Current Procedural Terminology (CPT) codes for all patients who underwent cubital tunnel release (CuTR) (CPT code 64718) from January 2012 till November 2018. Primary outcome was the need for revision surgery after initial CuTR. Univariate and multivariate analysis were performed to identify potential risk factors for revision surgery. In addition; Kaplan-Meier analysis was used to estimate cumulative risks of recurrence surgery. RESULTS In total, revision surgery was needed for 121 of the 682 patients (17.8%). Overall, cumulative risk of revision was 23% (95% CI = 19 – 28%). Cox regression analysis showed that age and spinal disc herniation (SDH) at cervical level were independent risk factors for recurrent surgery: Hazard Ratio was (HR)Age = 2.35; 95% CI = 1.38 – 4.00 and HRSDH = 1.62; 95% CI = 1.12 – 2.34, respectively. The corresponding cumulative risks of revision were 27% (95% CI = 23 – 35%) for patients younger than 48 years and 18% (95% CI = 13 – 23%) for patients older than 48 years. The cumulative risk of revision for patients with in situ release were significantly higher than for patients treated with other techniques i.e. transpositions or medial epicondylectomy; 37% (95% CI = 24 – 54%) vs. 21% (95% CI = 18 – 26%) (p = 0.033). CONCLUSION Younger age and having SDH at the cervical level are associated with an increased risk of revision surgery after CuTR. Patients should be informed about these risk factors during outpatient consultation. TYPE OF STUDY/LEVEL OF EVIDENCE Diagnostic, level IV.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Rijssen, A.L. van and Brohet, R.M. |
| Faculty: | Medical Sciences |
| Keywords: | Neurology, Cubital tunnel Syndrome, Recurrence, surgery |
| Date Deposited: | 14 Jul 2020 12:02 |
| Last Modified: | 14 Jul 2020 12:02 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2751 |
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