Open AccessNerve Conduction Studies in Surgical Cubital Tunnel Syndrome Patients
Author(s) -
Daniel Shubert,
Joseph Prud'homme,
Shafic Sraj
Publication year - 2019
Publication title -
hand
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.722
H-Index - 35
eISSN - 1558-9455
pISSN - 1558-9447
DOI - 10.1177/1558944719840750
Subject(s) - medicine , cubital tunnel syndrome , ulnar neuropathy , elbow , cubital tunnel , nerve conduction velocity , carpal tunnel syndrome , nerve conduction , ulnar nerve , concomitant , surgery , median nerve
Background: Electrodiagnostic studies (EDX) serve a prominent role in the diagnostic workup of cubital tunnel syndrome (CBTS), but their reported sensitivity varies widely. The goals of our study were to determine the sensitivity of EDX in a cohort of patients who responded well to surgical cubital tunnel release (CBTR), and whether the implementation of the Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) criteria improves the sensitivity. Methods: We identified 118 elbows with clinical CBTS who had preoperative EDX and underwent CBTR. The EDX diagnoses were CBTS, ulnar neuropathy (UN), and normal ulnar nerves. We divided the 118 elbows into those that received above-elbow stimulation (XE group) and those that did not (non-XE group). We calculated the sensitivities for all groups and reinterpreted the results according to the AANEM guidelines. Results: Cubital tunnel release provided significant relief in 93.6% of the elbows. Based on the EDX reports, 11% patients had clear CBTS, 23% had UN, and 66% showed no UN. The sensitivities were 11.7% for CBTS and 34.2% for any UN. In the XE group, the sensitivity of the EDX reports for CBTS and UN climbed to 33.3% and 58.3%, respectively. When we calculated the across-elbow motor nerve conduction velocity, the sensitivity for CBTS and UN was 87.5% and 100%, respectively. The XE and non-XE groups showed no difference except for sex, bilaterality, concomitant carpal tunnel release, and obesity ( P < .05). Conclusion: Implementing AANEM guidelines results in significant improvement in correlation of clinical and electrodiagnostic findings of CBTS.