Value of oxyneurography, based on near infrared spectroscopy, in the diagnosis of carpal tunnel syndrome in comparison to provocative clinical diagnostic tests and nerve conduction studies

摘要

Highlights ? Oxyneurography is as accurate as nerve conduction studies in the diagnosis of carpal tunnel syndrome. ? Oxyneurography is a non-invasive, fast and safe study. ? Oxyneurography index of less than 62% indicates the presence of carpal tunnel syndrome. Abstract Objective Evaluation of the diagnostic utility of the oxyneurography (ONG) in diagnosing carpal tunnel syndrome (CTS). Methods ONG examination of the median nerve was performed in 260 patients. The results were compared with nerve conduction studies and clinical provocative tests. Results ONG index greater than or equal to 62% was found in 95.18% of the patients with no or minimal Nerve Conduction Study (NCS) changes (1–2 according to the Padua classification) but only in 1.69% of the patients with advanced NCS changes (Padua 3–6). The sensitivity and specificity of the ONG study i.e. 95.18% and 98.31%, respectively, were compared with standard clinical tests: Tinel sign (61.45% and 14.69%), Phalen test (34.94% and 45.20%), reverse Phalen test (81.93% and 34.46%) and carpal compression test (91.57% and 72.32%). Conclusions ONG index lower than 62% was indicative of CTS. ONG has higher sensitivity and specificity then other clinical tests and it is an accurate and reliable method for the diagnosis of CTS. Significance Oxyneurography is a non-invasive, fast and safe study which may play role in the diagnosis of carpal tunnel syndrome.