Preoperative and Postoperative Evaluation of Electromyography and Magnetic Resonance Imaging Findings in Carpal Tunnel syndrome
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Introduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by the compression of the median nerve in the carpal tunnel in the wrist. In the diagnosis of CTS, neurological examination and electrophysiological studies (EMG) findings are based primarily. This study was conducted in order to determine how effective magnetic resonance imaging examining in the diagnosis and follow-up of patients diagnosed with carpal tunnel syndrome is. Material and methods: Our research was performed on 21 patients with 23 wrists diagnosed with CTS with clinical and electrophysiological tests. Magnetic resonance imaging (MRI) was performed preoperatively and postoperatively in 14.2 weeks for the hands of 21 patients in the anatomical prone position by using a wrist coil. The length and width measurements of the sections of the median nerve were proportionalized at three levels (length / width), and flattening ratio of the median nerve, median nerve area, the intensity of the median nerve were evaluated. All patients was operated by the same surgeon, neurolysis was not applied to any patient. Results: When the results of the EMG before and after surgery of the study group were analyzed, it has been detected that, there was a significant improvement in motor conduction velocity and sensory conduction time compared to preoperative results. Hand / wrist MRI of the study group was compared with the control group, it has been observed that, the arithmetic mean of all measurements, except the ratio of carpal tunnel area / wrist area were greater than the control group. The differences in terms of median nerve flattening ratio in the middle and distal, the distal median nerve area, flexor retinaculum thickness, flexor retinaculum spring, the flexor retinaculum spring ratio were not significant. Conclusion: Electrophysiological studies are the gold standard in the diagnosis of CTS. MRI is an effective method in the evaluation of patients after surgery. It may be used to reveal the cause of failed surgery. MR imaging is an effective method in the diagnosis of patients and in post-operative follow-up.