The Efficacy of Ultrasound Guided Platelet Rich Plasma Injection Versus Perineural Dextrose Injection in the Treatment of Severe Carpal Tunnel Syndrome
Manar Elsayed Shandal
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Tanta, Egypt.
Shaimaa Ahmed Hablas
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Tanta, Egypt.
Amal Mohamed Elbarbary
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Tanta, Egypt.
Elham Mohammed Kassem
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Tanta, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Aims: To compare the ultrasound-guided platelet rich plasma efficacy to ultrasound guided 5% dextrose perineural injection therapy in severe idiopathic carpal tunnel syndrome patients.
Patients and Methods: This research involved 60 patients with severe idiopathic CTS diagnosed by electrophysiological study. Patients were evaluated at three months after injection clinically, electrophysiological, and US examinations.
Patients were divided into 2 groups according to line of treatment:
Group I: 30 patients (34 hands) treated by two ultrasound guided injection with 3 mL PRP two weeks apart.
Group II: 30 patients (35 hands) treated by two ultrasound guided perineural injection therapy with 3 ml of 5% dextrose two weeks apart.
Results: There was significant clinical improvement (BCTQ and, VAS), electrophysiological improvement (DML, AMP, sensory amplitude and sensory conduction velocity of median nerve) and, ultrasonic improvement (CSA and FR) 3 month after treatment as compared to before treatment in both groups with better improvement in group 1.
There was significant difference between the 2 groups regarding VAS for pain and VAS for paresthesia 3 months after treatment with better improvement in PRP group. There was significant difference between the 2 groups regarding BCTQ 3 months after treatment with better improvement in PRP group.
Conclusion: Ultrasound guided injection of PRP or dextrose 5% is an effective and safe treatment for severe idiopathic CTS.
-Both modalities lead to significant reduction in pain, paresthesia, disability and also significant improvement in electrophysiological and ultrasound parameters of the median nerve with better improvement in PRP group.
Keywords: Carpal tunnel syndrome, ultrasound guided platelet rich plasma injection, perineural dextrose injection