Abstract Carpal tunnel syndrome (CTS) accounts for approximately 90% of peripheral entrapment neuropathy cases. Treatments of CTS as splinting, corticosteroid injection, and surgery are not 100% effective, and alternative treatments are worth exploring. Surgery indicated in patients with persistent numbness, pain, and motor dysfunction. Empirical evidence indicates that many patients with CTS respond to anti-inflammatory medications. Recently, major attention has been drawn to platelet-rich plasma (PRP) for its possible effects on axon regeneration and neurological recovery. Objectives To evaluate the therapeutic efficacy of single ultrasound guided PRP injection of CTS versus surgical procedures and medical treatment in patients with mild-moderate CTS regarding pain relief and function improvement. Methods Thirty patients were injected in the carpal tunnel with single ultrasound-guided PRP (1–2 ml) injections; 30 patients went to surgical procedure, and 30 patients received conventional medical treatment and hand support. They were followed by using VAS (visual analogue scale), Boston questionnaire for CTS, and nerve conduction study for clinical improvement. Results Both groups of patients who had received PRP injection and who underwent to surgery showed improvements in their scores of evaluation parameters at 6 months post intervention, while the third group that received medical treatment shows insignificant improvement at 6 months post treatment. Conclusion PRP can be considered as a safe, less invasive, and long-lasting alternative to surgery and effective with one shot session compared to medical treatment in management of mild-moderate CTS. Trial registration Clinical trial.govID: NCT04235426 . Unique protocol ID:1472. Verification date: January 2020.

中文翻译：

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富血小板血浆注射与轻中度心皮隧道综合征的手术和药物治疗

摘要 腕管综合征 (CTS) 约占周围卡压神经病变病例的 90%。夹板、皮质类固醇注射和手术治疗 CTS 并非 100% 有效，替代疗法值得探索。手术适用于持续麻木、疼痛和运动功能障碍的患者。经验证据表明，许多 CTS 患者对抗炎药物有反应。最近，富含血小板的血浆 (PRP) 对轴突再生和神经恢复的可能影响引起了人们的极大关注。目的 评估单次超声引导 PRP 注射 CTS 与外科手术和药物治疗在轻中度 CTS 患者疼痛缓解和功能改善方面的治疗效果。方法 30 名患者在腕管内注射单次超声引导的 PRP（1-2 ml）；30名患者接受了外科手术，30名患者接受了常规药物治疗和手部支撑。随后使用 VAS（视觉模拟量表）、波士顿 CTS 问卷和用于临床改善的神经传导研究。结果 注射PRP和手术治疗的两组患者在干预后6个月的评估参数评分均有改善，而接受药物治疗的第三组患者在治疗后6个月的评分改善不显着。结论 PRP 可以被认为是一种安全、侵入性较小、和持久的手术替代方案，与治疗轻中度 CTS 的药物治疗相比，一次注射有效。试验注册 Clinicaltrial.govID：NCT04235426。唯一协议 ID：1472。验证日期：2020 年 1 月。