Comparison of surgical treatment for Carpal Tunnel Syndrome with corticosteroid injection and platelet-rich plasma injection

Abstract

The most common entrapment neuropathy is carpal tunnel syndrome (CTS). Treatment options include both surgical and conservative procedures. The purpose of this study is to compare surgical treatment, corticosteroid injection, and platelet-rich plasma (PRP) injection in mild and moderate CTS and assess their clinical, electrophysiological, and ultrasonographic superiority over each other. This research was carried out using a prospective, randomized, controlled design. The study included 92 wrists from 68 participants with mild to moderate carpal tunnel syndrome. Following patient randomization, the first group underwent surgical treatment, the second group received steroid injections guided by ultrasonography, and the third group received PRP injections guided by ultrasonography. Prior to treatment, as well as one, three, and six months later, patients had evaluations. The patients’ functional status and the severity of their symptoms were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ), while the visual analog scale (VAS) was used to determine the patients’ pain levels. Patients also had electrodiagnostic examinations, and ultrasonography was used to measure the median nerve’s cross-sectional area (CSA) and flattening ratio (FR). The VAS and BCTQ showed significant improvements in all groups; however, surgical treatment outperformed the other two treatment modalities. While there was no significant change in compound muscle action potential amplitude in either group, surgical treatment was found to be superior in other electrophysiological measures. Before treatment, there was a difference in the groups’ CSA measurements, and following treatment, all three treatment groups showed significant improvements. FR remained unchanged across all groups. In patients with mild to moderate CTS, injection procedures are useful, but surgical treatment has been shown to be more effective in terms of both clinical outcomes and electrophysiological parameters.