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Endoscopic release for carpal tunnel syndrome

  1. Haris S Vasiliadis1,2,*,
  2. Petros Georgoulas3,
  3. Ian Shrier4,
  4. Georgia Salanti5,
  5. Rob JPM Scholten6

Editorial Group: Cochrane Neuromuscular Group

Published Online: 31 JAN 2014

Assessed as up-to-date: 5 NOV 2012

DOI: 10.1002/14651858.CD008265.pub2


How to Cite

Vasiliadis HS, Georgoulas P, Shrier I, Salanti G, Scholten RJPM. Endoscopic release for carpal tunnel syndrome. Cochrane Database of Systematic Reviews 2014, Issue 1. Art. No.: CD008265. DOI: 10.1002/14651858.CD008265.pub2.

Author Information

  1. 1

    University of Ioannina, Department of Orthopaedics, Ioannina, Greece

  2. 2

    Sahlgrenska University Hospital, Gothenburg University, Molecular Cell Biology and Regenerative Medicine, Gothenburg, Sweden

  3. 3

    University of Ioannina, Ioannina, Greece

  4. 4

    Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Centre for Clinical Epidemiology, Montreal, Quebec, Canada

  5. 5

    University of Ioannina School of Medicine, Department of Hygiene and Epidemiology, Ioannina, Greece

  6. 6

    University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, Netherlands

*Haris S Vasiliadis, Department of Orthopaedics, University of Ioannina, Ioannina, Greece. vasiliadismd@gmail.com. hvasil@cc.uoi.gr.

Publication History

  1. Publication Status: New
  2. Published Online: 31 JAN 2014

SEARCH

[Figure 1]
Figure 1. Study flow diagram (does not include the results of search in November 2013, which will be fully assessed in the next update).
[Figure 2]
Figure 2. 'Risk of bias' summary: review authors' judgements about each 'Risk of bias' item for each included study. Green (+) = low risk of bias; yellow (?) = unclear risk of bias; red (-) = high risk of bias
[Figure 3]
Figure 3. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.3 Symptom Severity Scale (Levine) at 3 months or less.
[Figure 4]
Figure 4. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.4 Function Status Scale at 3 months or less.
[Figure 5]
Figure 5. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.10 Grip strength at 3 months or less.
[Figure 6]
Figure 6. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.24 Minor complications.
[Figure 7]
Figure 7. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.25 Total complications.
[Figure 8]
Figure 8. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.6 Pain at 3 months or less (corr = 0.9).
[Figure 9]
Figure 9. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.8 Pain (dichotomous) at 3 months or less.
[Figure 10]
Figure 10. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.9 Numbness (dichotomous) at 3 months or less.
[Figure 11]
Figure 11. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.19 Grip strength at more than 3 months.
[Figure 12]
Figure 12. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.20 Time to return to work.
[Figure 13]
Figure 13. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.21 Recurrence.
[Figure 14]
Figure 14. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.22 Reoperations.
[Figure 15]
Figure 15. Forest plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.23 Major complications.
[Figure 16]
Figure 16. Funnel plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.21 Recurrence.
[Figure 17]
Figure 17. Funnel plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.22 Reoperations.
[Figure 18]
Figure 18. Funnel plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.23 Major complications.
[Figure 19]
Figure 19. Funnel plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.24 Minor complications.
[Figure 20]
Figure 20. Funnel plot of comparison: 1 Endoscopic versus open or mini-open carpal tunnel release, outcome: 1.25 Total complications.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 1 Overall improvement at 3 months or less.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 2 Overall satisfaction at 3 months or less.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 3 Symptom Severity Scale (Levine) at 3 months or less.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 4 Function Status Scale at 3 months or less.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 5 Pain at 3 months or less (corr = 0.5).
[Analysis 1.6]
Analysis 1.6. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 6 Pain at 3 months or less (corr = 0.9).
[Analysis 1.7]
Analysis 1.7. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 7 Pain at 3 months or less (corr = 0.1).
[Analysis 1.8]
Analysis 1.8. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 8 Pain (dichotomous) at 3 months or less.
[Analysis 1.9]
Analysis 1.9. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 9 Numbness (dichotomous) at 3 months or less.
[Analysis 1.10]
Analysis 1.10. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 10 Grip strength at 3 months or less.
[Analysis 1.11]
Analysis 1.11. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 11 Overall improvement at more than 3 months.
[Analysis 1.12]
Analysis 1.12. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 12 Overall satisfaction at more than 3 months.
[Analysis 1.13]
Analysis 1.13. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 13 Symptom Severity Scale (Levine) at more than 3 months.
[Analysis 1.14]
Analysis 1.14. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 14 Function Status Scale at more than 3 months.
[Analysis 1.15]
Analysis 1.15. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 15 Pain at more than 3 months.
[Analysis 1.16]
Analysis 1.16. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 16 Pain (dichotomous) at more than 3 months.
[Analysis 1.17]
Analysis 1.17. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 17 Numbness at more than 3 months.
[Analysis 1.18]
Analysis 1.18. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 18 Numbness (dichotomous) at more than 3 months.
[Analysis 1.19]
Analysis 1.19. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 19 Grip strength at more than 3 months.
[Analysis 1.20]
Analysis 1.20. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 20 Time to return to work.
[Analysis 1.21]
Analysis 1.21. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 21 Recurrence.
[Analysis 1.22]
Analysis 1.22. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 22 Reoperations.
[Analysis 1.23]
Analysis 1.23. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 23 Major complications.
[Analysis 1.24]
Analysis 1.24. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 24 Minor complications.
[Analysis 1.25]
Analysis 1.25. Comparison 1 Endoscopic versus open or mini-open carpal tunnel release, Outcome 25 Total complications.
[Analysis 2.1]
Analysis 2.1. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 1 Overall satisfaction at 3 months or less.
[Analysis 2.2]
Analysis 2.2. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 2 Overall improvement at 3 months or less.
[Analysis 2.3]
Analysis 2.3. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 3 Symptom Severity Scale (Levine) at 3 months or less.
[Analysis 2.4]
Analysis 2.4. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 4 Function Status Scale at 3 months or less.
[Analysis 2.5]
Analysis 2.5. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 5 Pain at 3 months or less (corr = 0.5).
[Analysis 2.6]
Analysis 2.6. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 6 Pain at 3 months or less (corr = 0.1).
[Analysis 2.7]
Analysis 2.7. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 7 Pain at 3 months or less (corr = 0.9).
[Analysis 2.8]
Analysis 2.8. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 8 Pain (dichotomous) at 3 months or less.
[Analysis 2.9]
Analysis 2.9. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 9 Numbness (dichotomous) at 3 months or less.
[Analysis 2.10]
Analysis 2.10. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 10 Grip strength at 3 months or less.
[Analysis 2.11]
Analysis 2.11. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 11 Overall satisfaction at more than 3 months.
[Analysis 2.12]
Analysis 2.12. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 12 Overall improvement at more than 3 months.
[Analysis 2.13]
Analysis 2.13. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 13 Symptom Severity Scale (Levine) at more than 3 months.
[Analysis 2.14]
Analysis 2.14. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 14 Function Status Scale at more than 3 months.
[Analysis 2.15]
Analysis 2.15. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 15 Pain at more than 3 months.
[Analysis 2.16]
Analysis 2.16. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 16 Pain (dichotomous) at more than 3 months.
[Analysis 2.17]
Analysis 2.17. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 17 Numbness at more than 3 months.
[Analysis 2.18]
Analysis 2.18. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 18 Numbness (dichotomous) at more than 3 months.
[Analysis 2.19]
Analysis 2.19. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 19 Grip strength at more than 3 months.
[Analysis 2.20]
Analysis 2.20. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 20 Time to return to work.
[Analysis 2.21]
Analysis 2.21. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 21 Recurrence.
[Analysis 2.22]
Analysis 2.22. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 22 Reoperations.
[Analysis 2.23]
Analysis 2.23. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 23 Major complications.
[Analysis 2.24]
Analysis 2.24. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 24 Minor complications.
[Analysis 2.25]
Analysis 2.25. Comparison 2 One- or two-portal endoscopic versus open and mini-open carpal tunnel release, Outcome 25 Total complications.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 1 Symptom Severity Scale (Levine) at 3 months or less.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 2 Function Status Scale at 3 months or less.
[Analysis 3.3]
Analysis 3.3. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 3 Pain at 3 months or less (corr = 0.5).
[Analysis 3.4]
Analysis 3.4. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 4 Pain at 3 months or less (corr = 0.1).
[Analysis 3.5]
Analysis 3.5. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 5 Pain at 3 months or less (corr = 0.9).
[Analysis 3.6]
Analysis 3.6. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 6 Grip strength at 3 months or less.
[Analysis 3.7]
Analysis 3.7. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 7 Pain (dichotomous) at more than 3 months.
[Analysis 3.8]
Analysis 3.8. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 8 Numbness (dichotomous) at more than 3 months.
[Analysis 3.9]
Analysis 3.9. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 9 Time to return to work.
[Analysis 3.10]
Analysis 3.10. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 10 Reoperations.
[Analysis 3.11]
Analysis 3.11. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 11 Major complications.
[Analysis 3.12]
Analysis 3.12. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 12 Minor complications.
[Analysis 3.13]
Analysis 3.13. Comparison 3 Sensitivity analysis 1 (low risk of bias for incomplete outcome data), Outcome 13 Total complications.
[Analysis 4.1]
Analysis 4.1. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 1 Overall improvement at more than 3 months.
[Analysis 4.2]
Analysis 4.2. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 2 Symptom Severity Scale (Levine) at 3 months or less.
[Analysis 4.3]
Analysis 4.3. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 3 Pain at 3 months or less (corr = 0.5).
[Analysis 4.4]
Analysis 4.4. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 4 Pain at 3 months or less (corr = 0.1).
[Analysis 4.5]
Analysis 4.5. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 5 Pain at 3 months or less (corr = 0.9).
[Analysis 4.6]
Analysis 4.6. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 6 Pain (dichotomous) at 3 months or less.
[Analysis 4.7]
Analysis 4.7. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 7 Pain (dichotomous) at more than 3 months.
[Analysis 4.8]
Analysis 4.8. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 8 Numbness (dichotomous) at 3 months or less.
[Analysis 4.9]
Analysis 4.9. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 9 Numbness (dichotomous) at more than 3 months.
[Analysis 4.10]
Analysis 4.10. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 10 Function Status Scale at 3 months or less.
[Analysis 4.11]
Analysis 4.11. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 11 Grip strength at 3 months or less.
[Analysis 4.12]
Analysis 4.12. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 12 Recurrence.
[Analysis 4.13]
Analysis 4.13. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 13 Reoperations.
[Analysis 4.14]
Analysis 4.14. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 14 Major complications.
[Analysis 4.15]
Analysis 4.15. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 15 Minor complications.
[Analysis 4.16]
Analysis 4.16. Comparison 4 Sensitivity analysis 2 (exclusion of inappropriate adjustment for bilateral involvement), Outcome 16 Total complications.