Increase in Cubital Tunnel Pressure: Cause or Effect of Cubital Tunnel Syndrome?

In this study surgeons measure the pressure inside the cubital tunnel alongside the elbow. The ulnar nerve runs through this tunnel. Pressure on the nerve can cause cubital tunnel syndrome (CTS). Patients with CTS have pain, numbness, tingling, and weakness of the hand. The goal was to find out if increased pressure on the nerve is the cause of CTS or a result of CTS.

Eight patients with CTS had surgery to remove the pressure from the nerve. During the operation, a microtransducer was gently placed inside the cubital tunnel. Pressures were measured at three different places. The measurements were taken first with the elbow fully flexed. The same measures were taken again with the elbow fully extended.

Pressures were the highest closest to the elbow and during elbow flexion. Patients with the highest pressures had the worst disease. As the disease progressed pressures increased in both flexion and extension.

>From the results of this study the authors believe that pressure from outside the nerve is linked with CTS. They also say that pressure inside the nerve adds to the problem. They recommend a two-part surgery to take pressure off the nerve and to move the nerve out of the tunnel. A simple decompression is not enough.

References: Kousuke Iba, MD, et al. Intraoperative Measurement of Pressure Adjacent to the Ulnar Nerve in Patients with Cubital Tunnel Syndrome. In The Journal of Hand Surgery. April 2006. Vol. 31A. No. 4. Pp. 553-558.