Bipolar pulsed radiofrequency neuromodulation of median nerve for treatment of carpal tunnel syndrome – a preliminary study

Abstract

I N T R O D U C T I O N: The results of direct surgical release of the median nerve in patients with carpal tunnel syndrome are frequently far from being satisfactory. Aim of the presented study is to assess the early results of bipolar pulsed radiofrequency (PRF) neuromodulation of the median nerve (MN) for treatment of carpal tunnel syndrome (CTS). M A T E R I A L A N D M E T H O D S: Fifteen adult patients with CTS (10 women and 5 men, mean age 58.5 years) were treated. The bipolar technique of neuromodulation was applied, with confirmation of the correct electrode position by neurophysiological examination. The study protocol included the Boston Carpal Tunnel Questionnaire (BCTQ), Numerical Rating Scale (NRS) for pain assessment and tip pinch strength assessment performed before neuromodulation as well as 4 and 12 weeks after treatment. Moreover, the sensory nerve conduction velocity (SNCV) was assessed before and 12 weeks after the intervention. R E S U L T S: A significant improvement in symptom severity (33.53 ± 8.25 at the baseline vs. 18.33 ± 11.06 and 25.67 ± 12.39 at 4 and 12 weeks) and functional status (21.0 ± 5.79 vs. 12.07 ± 7.20 and 17.73 ± 9.09) BCTQ subscores, as well as tip pinch strength (3.39 ± 1.68 vs. 5.86 ± 1.98 and 4.93 ± 2.22) were observed. A reduction in pain and improvement in SNCV were also found, but did not reach statistical significance. C O N C L U S I O N S: Bipolar PRF neuromodulation of MN is a promising therapeutic tool for patients with CTS and could potentially be an alternative to direct surgical release of MN. A longer follow-up period is required to assess the longevity of clinical improvement after the treatment.

Keywords

• bipolar neuromodulation
• carpal tunnel syndrome
• median nerve
• pulsed radiofrequency