Dr.
Lee Berger
Developer of the Balloon Carpal Tunnel-Plasty
BALLOON CARPAL TUNNEL-PLASTY: RECENT
DEVELOPMENT IN CTS SURGICAL TECHNIQUE PRODUCES EXCELLENT RESULTS
Carpal
Tunnel Syndrome is a painful condition of the hand resulting from
compression of the median nerve within the carpal canal. It is the most
common peripheral nerve entrapment syndrome of the upper extremity.
Historically, many treatments of carpal tunnel syndrome have been
proposed including non-operative methods, open surgical release and
endoscopic techniques. There are inherent problems with open or
endoscopic carpal tunnel release which involve cutting the transverse
carpal ligament.
The
complications of these procedures include painful scars. The formation
of the scar tissue between the transected edges of the ligament and
perineural fibrosis of the median nerve. When the ligament is
transected, there is increased excursion of the flexor tendons with loss
of grip strength. Neurovascular injuries have been reported particularly
with the endoscopic technique.
Over the
past five years a new, minimally invasive operative procedure for the
treatment of carpal tunnel syndrome has been developed. The procedure
termed "Balloon Carpal Tunnel-Plasty" has been developed to dilate and
expand the transverse carpal ligament to increase the spatial diameter
of the carpal tunnel and relieve pressure on the median nerve
alleviating symptoms of carpal tunnel syndrome.
The
procedure utilizes a balloon catheter device similar to an angioplasty
balloon, pressure gauge monitor, as well as, a custom designed nerve
protector which protects the median nerve and canal contents during
balloon inflation. The catheter is inserted into the carpal canal
through a one centimeter incision portal at the distal wrist crease.
Research of
this new procedure included anatomical study including compartment
pressure measurement and histological analysis of carpal tunnel.
Clinical studies have been performed over the past four years in over
120 patients with excellent results and a high patient satisfaction rate
of 95%.
Balloon
Carpal Tunnel-Plasty is safe, effective and easy to perform. It is
unique compared to other surgical techniques for the treatment of carpal
tunnel syndrome in that it avoids transecting the transverse carpal
ligament which serves as a protective purpose in the palm, is important
to maintain the integrity of flexor tendon biomechanics and is important
for grip strength. The procedure reduces the potential for scar
formation within the carpal tunnel and decreases the likelihood of
perineural fibrosis of the median nerve. Patients have little
post-operative pain with a quick recovery time allowing an early return
to work and to activities of daily living.
