Carpal Tunnel Syndrome Side Effects: Big Surgeries, Big Complications
POSTED ON 2/19/2013 IN Hand and Wrist BY Christopher Centeno
Do Carpal tunnel syndrome side effects and complications exist? Patients often look at surgery as a "fix", much like going into a mechanic to get a new part installed or a tune up. Nothing could be further from reality. The reason why we push so hard in the direction of using biologics through injection is that it reduces the chance of serious complications. Here's a case in point. This poor gentleman came to us for carpal tunnel syndrome. He was a good candidate for a procedure called nerve hydrodissection. Instead of open surgery, a very careful and exact injection is undertaken with a fine needle to treat carpal tunnel. We inject growth factors around the median nerve while visualizing the injection under ultrasound imaging. We've seen very good success rates with the procedure, which is minimally invasive and we've never had a major complication and the likelihood one would occur with a needle is very small. Unfortunately for this gentleman, because of insurance coverage issues he had no choice but to undertake much more invasive carpal tunnel surgery and so undertook the risk of carpal tunnel syndrome side effects and complications. For whatever reason, he developed a compartment syndrome after the procedure. While this is a rare complication, it is possible. This is where swelling causes a build-up of pressure in a confined space (in this case the forearm). The only solution to avoid nerve damage or gangrene is major surgery to fillet open the tissues and reduce the pressure. In this case, the same median nerve they sought to decompress with the original carpal tunnel surgery was at risk for getting killed off by the pressure. Above are his immediate post-op images after the major decompression surgery in the forearm (two images to the left) and then the large scar that resulted from the procedure. What's the status of his carpal tunnel syndrome? Worse than ever. While we can't guarantee we could have effectively treated his carpal tunnel syndrome through injection, we can say that in our clinical experience, the likelihood of getting a compartment syndrome from the injection was almost nil. The upshot? Big surgeries using scalpels can have big side effects, less invasive procedures using needles have generally much fewer side effects.
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