ULTRASOUND GUIDED SURGERY

CARPAL TUNNEL RELEASE (NOTE: This is a preliminary outcome study)

Background: The original operations for carpal tunnel syndrome were done with an open surgical approach and general anesthesia. Arthroscopic techniques were then developed using regional anesthesia. At present the procedure can be done with the “camera” outside the body and the incision as small as 1 mm.

Rojo-Manaute and Associates did a randomized controlled study of ultrasound-guided versus mini-open (<2 cm incision) carpal tunnel release and found 2 to 3 times better function and lower pain scores at 1 week and 6 months with the ultrasound technique. We have done over 150 of these operations without significant complications.

Status: We continue to track outcomes following ultrasound-guided carpal tunnel release using the Sonex device and have completed 74 cases. Assessments are obtained pre-procedure, at 2 weeks, 1 month, 3 months, 6 months and 1 year.

NERVE CONDUCTION POST CARPAL TUNNEL RELEASE

Purpose: To assess the median nerve conduction and hand function one year following ultrasound-guided carpal tunnel release. 

Background and Significance: A common diagnosis that we treat is that of Carpal Tunnel Syndrome (CTS). An electromyography (EMG)/nerve conduction study (NCS) is a standard test used worldwide to access median nerve function and is a common tool used to help diagnose CTS. A long-term solution to CTS is ultrasound-guided carpal tunnel release surgery which Dr. Bodor performs routinely. All patients that have this surgery have already had an EMG/NCS done. Physicians (including Dr. Bodor) routinely use subjective data to assess whether the surgery was successful by means of standard questionnaires. We want to enhance the patient’s follow-up by adding objective information and seeing whether the median nerve conduction improves 1-year post surgery. This information combined with the subjective information can give the medical community a better understanding as to whether ultrasound-guided carpal tunnel surgery improves the function of the nerve for patients. 

Methods: Once a year has elapsed from surgery, patients will become candidates for the repeat electromyography/nerve conduction study. We are hoping to enroll 40-50 patients. 

      1. Nerve Conduction Study:  Nerve conduction studies (NCS) are performed by administering an electric stimulus to the skin above the location of the nerve, then recording the nerve’s signal at a specified location.  The skin is not penetrated with this test.
      2. Electromyography: Electromyography (EMG) is performed by penetrating the skin with a fine wire (referred to as a needle) electrode, on the order of 30-gauge, then assessing the presence or absence of electrical activity and waveforms at rest and with gentle muscle activation.

Status: Currently 8 patients have been enrolled with the goal of enrolling 50.

SHOULDER INJURY FROM VACCINE ADMINISTRATION (SIRVA)

Our paper showcasing the technique and outcomes of our 5 successfully treated SIRVA patients has been submitted to Vaccine and is currently under review. 

 Reduce Pain. Increase Mobility & Function. Improve Quality of Life.

All the research conducted through the Napa Medical Research Foundation, a 501(c)(3) nonprofit organization, is fully funded through generous donations received from individuals and family foundations.