Thread carpal tunnel release vs. minimally invasive carpal tunnel release: a systematic review and meta-analysis

The goal of this systematic review and meta-analysis was to compare outcomes between ultrasound-guided thread carpal tunnel release (TCTR) and other minimally invasive surgerical techniques (MIS), for the treatment of Carpal Tunnel Syndrome. This systematic review was conducted according to PRISMA 2020 guidelines. Randomized controlled trials, cohort studies, and case series examining TCTR or MIS in adults (≥18 years) diagnosed with CTS were examined. Included studies must have reported pain, sensation, or functionality scores. Five studies met inclusion criteria, comprising 389 patients. Mean follow-up for functionality and symptom severity scores were 8 months and 3.25 months for pain outcomes. Both TCTR and MIS demonstrated significant improvements in all outcomes. While within-group analayese suggested greater statistical robust improvement for symptom severity in the TCTR group (p < 0.01, Hedge’s G = −3.25 [−4.42, −2.08], I2 = 83.1%) compared to MIS group (p = 0.05, Hedge’s G = −2.16 [−4.32, −0.00], I2 = 99.3%), subgroup analysis did not demonstrate significant differences between TCTR and MIS for any outcomes. TCTR demonstrates comparable clinical outcomes to other minimally invasive carpal tunnel release techniques, suggesting that TCTR represents a viable minimally invasive option to the surgical management of CTS. The www.crd.york.ac.uk/prospero identifier is CRD42024598274. Carpal tunnel syndrome is a condition affecting 1 in 10 individuals that causes pain, numbness, and tingling in the hand and wrist due to pressure on the median nerve. When symptoms do not improve with nonsurgical conservative treatments, surgery is often needed to relieve this pressure. This study compared modern surgical techniques for treating carpal tunnel: Threaded Carpal Tunnel Release (TCTR) or minimally invasive surgery. Researchers reviewed and combined data from five previously published studies involving 389 patients. Researchers found that both TCTR and MIS were equally effective in improving hand function, reducing pain, and easing symptoms. However, TCTR group showed slightly larger improvements in hand function suggesting that it may allow faster recovery and return to daily activities. Researchers reported the need for larger studies with longer-term follow-up to confirm these findings and determine whether one method offers lasting advantages.