Predictors for Postoperative Nerve Recovery in Severe Carpal Tunnel Syndrome

Zixuan Luo,1 Tao Ma,2 Siyu Tian,3 Kunlun Yu,4 Dehu Tian4 1Department of Foot Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People’s Republic of China; 2Department of Trauma Emergency Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, 075000, People’s Republic of China; 3Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People’s Republic of China; 4Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People’s Republic of ChinaCorrespondence: Dehu Tian, Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People’s Republic of China, Email [email protected]: Severe carpal tunnel syndrome (CTS) is a nerve compression disease that can lead to muscle atrophy from denervation. However, research on neurological recovery after surgery in severe CTS patients is relatively limited. This study mainly explores the predictors for poor postoperative neurological recovery in severe CTS patients.Methods: This study collected data of severe CTS patients who received surgery in our hospital from January 2022 to January 2024. According to the recovery of nerve function during follow-up, patients were divided into two groups. Clinical data of severe CTS patients were analyzed.Results: Age (P< 0.001), disease duration (P=0.013), and 2-PD (P< 0.001) of patients were closely related to poor postoperative neurological recovery at 6-month follow-up. Logistic regression analysis showed that age (P=0.011) and 2-point discrimination (2-PD) (P=0.001) were independent risk factors for poor neurological function recovery at 6 months follow-up and the cutoff values of age and 2-PD were 53 years and 13.5 mm, respectively. Univariate analysis showed that age (P=0.044), disease duration (P=0.015), 2-PD (P< 0.001), and grip strength (P=0.005) were closely related to poor postoperative neurological recovery at 12-month follow-up. Logistic regression analysis showed that 2-PD (P=0.034) was a predictor of poor neurological function recovery at 12-month follow-up and the cutoff value of 2-PD was 13.5 mm.Conclusion: We found that age and 2-PD were independent risk factors for poor neurological function recovery at 6-month follow-up. However, 2-PD is a predictor for poor neurological recovery at 1-year follow-up. We also identified their cutoff values. This study helps us to personalize the risk of postoperative neurological recovery in patients with severe CTS in order to provide targeted early intervention.Keywords: carpal tunnel syndrome, 2-point discrimination, predictors, poor neurological recovery