Considering Revision Surgery
In Oct. 2018, I had carpal tunnel release on my right hand. After symptoms returned, my neurosurgeon ordered an MRI of my right hand and wrist which showed "a large amount of scar tissue exerting a mass effect on the median nerve". EMG results were normal. It was decided to watch and wait to see if this resolved on its own and, if not, consider revision surgery.
Now, at 13 months post-op, the scar tissue remains and I continue to have right-hand pain similar to that before the first surgery.
Any guidance is much appreciated.
Thanks very much for your reply, Dr. Bland.
Before surgery, NCS showed "a mild right median neuropathy at the wrist (carpal tunnel), with findings consisting of mild sensory slowing through the wrist. APB latency of 3.45 ms. No motor abnormalities found. Overall severity of the findings is minimal."
I will investigate ultrasound imaging.
That sounds as though the evidence for CTS on the NCS was pretty marginal making you not a good candidate for surgery to start off with. If you have the actual results I can take a look if you email them to me. The second question is what exactly were the symptoms before surgery? If you can remember what it was like before surgical interference it would be worth completing the diagnostic questionnaire here for the symptoms as they were before the operation. JB
I guess the first question is whether the NCS results were abnormal before surgery, If not then normal results before and after surgery and no change in the symptoms would tend to suggest an incorrect diagnosis, whatever the MRI shows now. Ultrasound imaging is better than MRI for assessing the anatomy of the carpal tunnel after surgery if there is someone local with the expertise. Serial NCS can also be used to look for deterioration over time if it is thought that something is compromising the nerve.I have a friend in Michigan not too far from you (at least it didn't take me too long to drive from Chicago to Lansing) who is good at CTS, though he's not an ultrasound person unfortunately. JB