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.