Evaluation of the Prognostic Value of Preoperative Electromyography in Patients Who Underwent Carpal Tunnel Release Surgery

Objective: Carpal tunnel syndrome is a condition caused by the compression of the median nerve within the carpal tunnel, resulting in clinical symptoms in the area innervated by the nerve. The role of electromyography in surgical planning for carpal tunnel syndrome is controversial. The current study aimed to compare the clinical results of patients who underwent carpal tunnel release surgery based on their preoperative electromyography grading. Methods: We examined 102 patients who underwent carpal tunnel release surgery between 2015 and 2018. All patients were evaluated by electromyography preoperatively and 2-year postoperatively and completed the Boston Questionnaire. Based on the Bland classification for electromyography grades, the patients were divided into 2 groups: group 1 (grades 1-3) and group 2 (grades 4-6). Changes in scores were analyzed after carpal tunnel release surgery for each group. Results: When considering the results for all patients irrespective of group, both scores showed significant improvement after surgery. Group 2 exhibited greater improvement in the functional status scale score and electromyography grade compared to group 1, while similar changes were observed in the symptom severity scale scores. Conclusion: Both the symptom severity scale and functional status scale scores improved significantly after surgery for all patients. However, group 1 consistently had lower scores than group 2 across all evaluation periods. The evaluation of the improvement in the electromyography grade (ΔEMG) indicated that group 2 had better improvement than group 1. Level of Evidence: III