RSNA: Lasting Benefit Seen for Hydrodissection in Carpal Tunnel Syndrome

WEDNESDAY, Nov. 30, 2022 (HealthDay News) -- For patients with carpal tunnel syndrome (CTS), ultrasound-guided hydrodissection of the median nerve with normal saline (NS) alone offers significant and lasting benefit, according to a study presented at the annual meeting of the Radiological Society of North America, held from Nov. 27 to Dec. 1 in Chicago.

Anindita Bose, M.B.B.S., M.D., from the University College of Medical Sciences and Guru Teg Bahadur Hospital in New Delhi, India, and colleagues enrolled 63 wrists with refractory CTS to examine the effectiveness of true hydrodissection. Participants were randomly assigned into three groups. Two groups underwent ultrasound-guided hydrodissection: group 1 with NS alone and group 2 with NS and steroid mixture. Group 3 received guided perineural corticosteroid injection without hydrodissection.

The researchers observed significant improvement in the mean Boston Carpal Tunnel Questionnaire (BCTQ) score and visual analog scale (VAS) score in all three groups at four weeks (61.9, 85.7, and 100 percent in groups 1, 2, and 3, respectively). Further improvement was seen at weeks 12 and 24 in both hydrodissection groups (95.2 and 96 percent for groups 1 and 2, respectively), while there was a recurrence of symptoms and increase in BCTQ and VAS scores in group 3. Compared with the steroid group, the reduction in the median nerve cross-sectional area was more marked and similar in both hydrodissection groups (43 and 46 percent versus 11 percent at 12 weeks in groups 1 and 2 versus 3, respectively).

"It came as a pleasant surprise when this simple procedure of ultrasound-guided hydrodissection provided patients with long-term relief," a coauthor said in a statement.

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