Purpose
Considering the cost of, discomfort with, and time required for nerve conduction testing,
the Carpal Tunnel Syndrome-6 (CTS-6) is often used to determine the likelihood of
the presence of carpal tunnel syndrome. We sought to determine whether the CTS-6,
designed as a diagnostic instrument, could serve a dual purpose and predict the outcome
of carpal tunnel release (CTR) based on postoperative changes in the Boston Carpal
Tunnel Questionnaire (BCTQ) score.
Methods
This prospective observational study enrolled 118 adults before they underwent open
CTR at a tertiary center. A primary regression analysis was used to determine the
association between preoperative CTS-6 scores and changes in the BCTQ score at ≥6
months after surgery. Additional demographic, social, electrodiagnostic, and mental
health variables were assessed for associations with changes in the BCTQ score. The
secondary outcomes included single questions rating satisfaction with the result of
CTR as well as symptom changes and the Decision Regret Scale. Noneffective CTR was
defined as a BCTQ score change of <1.0 point or reported dissatisfaction.
Results
Postoperatively, the BCTQ score improvement averaged 1.38 ± 0.77. Although 102 of
109 patients (94%) noted symptom improvement, 94 of 109 (86%) were satisfied with
the result of CTR, and 78 of 109 patients (72%) demonstrated a meaningful change in
the BCTQ score. Preoperative CTS-6 scores were not correlated with changes in BCTQ
scores. CTS-6 scores were not associated with Decision Regret Scale scores, reported
satisfaction, or the single-question assessment of symptom changes. Satisfaction,
decision regret, and the single symptom change question were correlated with changes
in the BCTQ score and each other. Dissatisfied patients were distinguished by a differential
improvement in the BCTQ score (1.5 vs 0.7), but no preoperative variable consistently
predicted noneffective CTR.
Conclusions
The CTS-6 score does not predict changes in BCTQ scores after CTR. Patient satisfaction
with surgical results is associated with postoperative changes in carpal tunnel symptoms
but is not predictable using preoperative information. A single question of symptom
change may offer an efficient assessment of CTR outcomes.
Type of study/level of evidence
Prognostic II.
Key words
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Article info
Publication history
Published online: August 05, 2022
Accepted:
June 15,
2022
Received:
October 11,
2021
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
