Endoscopic Neurosurgery of Tunnel Syndrome

I.N. Shevelev, S.O. Arestov, A.V. Shtok

Burdenko Research Institute of Neurosurgery, Moscow, Russia


Introduction. Tunnel lesions of nerve trunks of upper extremities are the most widespread pathology. The results of screening, carried out by us, revealed a high rate of morbidity (up to 45.8%) among employees, engaged in manual labor and experiencing long-term overload of muscles. This problem is rather urgent, as the disease peak falls on rather young and able-bodied persons and highly qualified workers.

Material and Methods. We used original endoscopic technique, developed by K. Krishna (Germany). It should be emphasized, that a set contains a unique dilator, which allows to manipulate at a great depth without widening an approach. An endoscope (4 mm) with an angular view of 90o was used (Karl Storz).

Results. There were 32 operated cases (17 with carpal tunnel syndrome and 15 with cubital tunnel syndrome). It was noted, that local anesthesia was quite sufficient for performing such operations. Preoperative reduction of muscle strength was watched in 21 cases. Operation resulted in its increase. All the cases demonstrated partial or complete restoration of sensitivity after operation.

Conclusion. Endoscopic decompression of peripheral nerves in cases with tunnel syndromes is a minimum-invasive and effective substitute for standard neurosurgical approaches, performed in this pathology.