Carpal Tunnel Decompression Surgery

Surgery for Carpal Tunnel Syndrome

Figure B - Carpal tunnel syndrome illustration

The carpal tunnel, located at the wrist, is surrounded by carpal bones and the transverse carpal ligament. The median nerve passes through the carpal tunnel along with nine tendons (see figure A). The median nerve supplies sensation to all but the fifth finger (see figure B). When inflammation occurs within the carpal tunnel, it creates pressure on the nerve, resulting in numbness, tingling, and pain in the affected fingers, sometimes radiating up the arm. Night symptoms are common with significant nerve compression.

An electromyelogram (EMG) confirms the diagnosis of carpal tunnel syndrome and grades the severity of the pressure on the median nerve. Moderate to severe cases are usually unresponsive to these measures and will usually require carpal tunnel surgery for surgical decompression of the carpal tunnel.

Using local anesthesia, carpal tunnel decompression involves incising the transverse carpal ligament to open the carpal tunnel, thereby releasing the pressure on the median nerve. The procedure is highly successful in alleviating symptoms; it requires approximately six to eight weeks for convalescence.