수근관증후군 환자에서 정중신경 이중압궤증후군의 발생빈도

Abstract

Carpal tunnel syndrome (CTS) has been known to be frequently accompanied by cervical radiculopathy, which has been called as double crush syndrome (DCS). The objective of this study is to find out how often the CTS is accompanied by the cervical radiculopathy, and if there are any significant causative factors for this association. 126 patients with CTS proven by electrodiagnostic test were reviewed and divided into 2 groups; simple CTS (without concurrent cervical radiculopathy) and DCS group. Then, their clinical and electrophysiological differences were analyzed and the results were as follows.

1) Ninety-five patients out of 126 (75.4%) had probable concurrent cervical radiculopathy.

2) Complaints of pain in the neck, shoulder and upper arm were significantly more common in the DCS group than in the simple CTS group (p<0.05)

3) No significant difference between the DCS group and the simple CTS group existed in mean age, female percentage, sensory change or weakness of hand, bilaterality of CTS, and severity of abnormal nerve conduction studies of median nerve.

4) On needle electromyographic examination, the incidence for abnormal spontaneous activities such as fibrillation or positive sharp wave from abductor pollicis brevis muscle was higher in DCS group compared with simple CTS group (p<0.05). In flexor carpi radialis muscle and abductor digiti quinti muscle or first dorsal interosseus muscle, abnormal spontaneous activities appeared in DCS group only.

Therefore, clinically as well as electrophysiologically suspected CTS should be differenciated from cervical radiculopathy and looked for coexistence of cervical radiculopathy (DCS) by complete needle electromyographic examination including paracervical muscles.