CTS is caused by the compression of the median nerve through the carpal tunnel in the wrist area. When constricted, blood cannot flow freely through the hand to the fingers causing individuals with CTS to experience numbness and pain in the hand.
A recent study took place to evaluate the effects of bariatric surgery in patients with a pre-surgical diagnosis of CTS. Sixteen patients who were classified as obese to morbidly obese took part in the study. Each had a body mass index (BMI) ranging from 36 to 44, and a previous diagnosis of CTS confirmed by nerve conduction studies. The patients were evaluated by clinical and neurophysiological tests over a 12 to 23 week period after BSP.
In 14 patients, a significant and progressive improvement in clinical and neurophysiological evaluation performed after BSP was observed. This improvement directly correlated with a reduction of BMI to a range of 29 to 34, with an adjustment of the associated conditions. In two patients, no neurological function improvement was noted, however there was improvement in numbness and pain sensation. They did however, notice distinct improvement in the degree of numbness and pain. These two patients maintained their nerve conduction data.
The improvement on the outcome of CTS after BSP can be related to a decrease of fatty tissue in the carpal tunnel or may be due to a reduction of the hydrostatic pressure through it. According to Dr. Alexandre Recchia, “This study showed a significant and progressive improvement in clinical and neurophysiological evaluation of carpal tunnel syndrome performed after bariatric surgery. This improvement will lead physicians to adopt a more conservative therapeutic approach, avoiding an unnecessary and premeditated surgery. The study also emphasizes the beneficial effects of weight reduction on other diseases commonly associated with patients classified as morbidly obese, such as hypertension and diabetes mellitus. There is evidence of a significant improvement in some patients in the therapeutic management of these associated diseases.”
The complete findings and results of this study are being presented at the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) 56th Annual Meeting in San Diego, California, at the Manchester Grand Hyatt, October 7-10, 2009. With over 5000 members, the AANEM is the world’s largest organization dedicated to advancing neuromuscular, musculoskeletal, and electrodiagnostic medicine.
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