Publication: Infiltración e hidrodisección ecoguiada en el tratamiento del síndrome de túnel carpiano
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2017-02-20
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Universidad Complutense de Madrid
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Abstract
El síndrome de túnel carpiano (STC) es uno de los trastornos del nervio periférico mas frecuentes, con una prevalencia del 5,8% en mujeres y 0,6% en hombres. Aunque es considerado a veces como una patología trivial, representa un problema de salud importante siendo, junto a la sordera, el trastorno que mas morbilidad presentaban en número de casos y absentismo laboral en la población trabajadora de Estados Unidos. En cuanto al tratamiento, la descompresión quirúrgica tiene unos resultados dispares, con un éxito general del 75%. El tratamiento conservador, que es el utilizado inicialmente en la mayoría de los pacientes con STC, ha sido poco estudiado y varios tratamientos ampliamente utilizados. El uso de los antiinflamatorios no esteroideos no está sustentado en evidencia de ensayos clínicos controlados, aleatorizados en una población representativa (clase 1). Los corticoides mejoran la isquemia focal y reducen la sinovitis y la congestión vascular en el túnel carpiano. En teoría, la infiltración con corticoides solamente puede producir un alivio sintomático a corto plazo, siempre y cuando persista la causa mecánica que genera el síndrome. Sin embargo, la eficacia de la infiltración local con corticoides en el túnel carpiano como tratamiento a largo plazo sigue siendo controvertida...
Carpal tunnel syndrome (CTS) is one of the most common peripheral nerve disorders, with a population prevalence of 5.8% in women and 0.6% in men. Although has been considered a trivial condition, it causes a significant health problem. CTS and hearing impairment was found to account for more morbidity, measured by cases and working days lost, than any other condition in the US working population. Although CTS is generally considered to be a highly treatable condition, the definitive procedure of surgical decompression remains controversial, with an overall success rate about 75%. The nonsurgical management has not been deeply studied, and several widely used treatments, for example nonsteroidal anti-inflammatory agents, are actually supported by no class 1 trial evidence at all. Steroids relieve local ischemia and reduce synovial swelling or vascular congestion in the carpal tunnel. Theoretically, steroid injection may only provide short-term relief as long as the mechanical restriction persists. However the effectiveness of local steroid injection into the carpal tunnel, as a long-term treatment, remains controversial...
Carpal tunnel syndrome (CTS) is one of the most common peripheral nerve disorders, with a population prevalence of 5.8% in women and 0.6% in men. Although has been considered a trivial condition, it causes a significant health problem. CTS and hearing impairment was found to account for more morbidity, measured by cases and working days lost, than any other condition in the US working population. Although CTS is generally considered to be a highly treatable condition, the definitive procedure of surgical decompression remains controversial, with an overall success rate about 75%. The nonsurgical management has not been deeply studied, and several widely used treatments, for example nonsteroidal anti-inflammatory agents, are actually supported by no class 1 trial evidence at all. Steroids relieve local ischemia and reduce synovial swelling or vascular congestion in the carpal tunnel. Theoretically, steroid injection may only provide short-term relief as long as the mechanical restriction persists. However the effectiveness of local steroid injection into the carpal tunnel, as a long-term treatment, remains controversial...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 03/11/2015