Diagnostics and treatment of tunnel neuropathies

• Main Authors: Oleksandr Lemeshov, Iurii Chyrka
• Format: Article
• Language: English
• Published: Interdisciplinary Academy of Pain Medicine 2020-04-01
• Series: Медицина болю
• Subjects: compression neuropathy; tunnel syndrome; hand pain; carpal tunnel syndrome; cubital tunnel syndrome; thoracic outlet syndrome; tibial nerve; foot weakness
• Online Access: https://painmedicine.org.ua/index.php/pnmdcn/article/view/218
• ISSN: 2414-3812; 2519-2752

Relevance. Tunnel neuropathy – a damage of the peripheral nervous system that are common and range from 8 to 52 % of all diseases of the nervous system. Objective. To show the main features of the diagnosis and treatment of various tunnel neuropathy. Materials and Methods. Considerable experience of effective surgical treatment of tunnel neuropathies. 481 operations were performed during 2014–2019. The experience is described and structured. Results. The most common tunnel neuropathy of the upper extremity: carpal tunnel syndrome, pronator teres syndrome, cubital tunnel syndrome, Guyon's canal syndrome, radial neuropathy, thoracic outlet syndrome. Lower extremity: tarsal tunnel syndrome, Bernhardt – Roth syndrome, neuropathy of the peroneal nerve and its superficial branch. From 6.7 % to 78 % of patients with tunnel neuropathies, double crush syndrome occurs – nerve compression at two levels, which is more common in patients with diabetes mellitus. Such diseases are diagnosed clinically and instrumentally – electromyography, ultrasound, MRI. All the above pathologies are effectively treated surgically, which aims at decompression of the affected nerve. An important factor in complex treatment is early rehabilitation and physiotherapy procedures. Conclusions. Tunnel neuropathy is a common pathology that is effectively treated surgically. Diseases should be timely diagnosed to prevent severe and irreversible changes.