{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T06:21:04Z","timestamp":1780726864005,"version":"3.54.1"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Carpal tunnel syndrome (CTS) presents bilaterally in nearly 60%\u201370% of affected patients. Bilateral carpal tunnel release (CTR) can be performed in a staged or simultaneous fashion. There remains a limited understanding of the optimal preoperative factors to use for patient selection when determining simultaneous versus staged bilateral CTR. Moreover, it is unclear how these factors influence postoperative outcomes. In this study, the authors aimed to identify and compare preoperative comorbidities and postoperative outcomes in patients who had undergone simultaneous versus staged open and endoscopic bilateral CTR.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors performed a retrospective analysis of data collected from the TriNetX database. Patients with bilateral CTS who had been treated from February 1, 2002, to February 1, 2022, were dichotomized by their bilateral release approach: simultaneous or staged within 3 months. The resulting groups were analyzed separately by open versus endoscopic techniques. Next, cohorts were analyzed for preoperative comorbidities to identify possible factors for surgical determination. Then, they were propensity score matched on demographics and comorbidities. Postoperative outcomes within 6 months of surgery were measured with and without matching.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>After matching, 9286 and 3709 patients remained in the open and endoscopic groups, respectively. Those who had undergone staged surgeries via an open or endoscopic approach had more preoperative comorbidities. After matching, staged open release was associated with significantly higher rates of postprocedural care, hand\/joint pain, limb pain, trigger finger, and upper respiratory tract infections. Simultaneous open release was associated with higher rates of emergency room visits. Staged endoscopic release was associated with significantly higher rates of postprocedural care, limb pain, and trigger finger. No significant outcomes were favored in the simultaneous endoscopic group.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Before matching, patients who had undergone staged CTR had significantly higher rates of preoperative medical comorbidities compared with patients in the simultaneous CTR group. Moreover, staged CTR was significantly associated with higher rates of postoperative complications. After matching on demographics and comorbidities, staged CTR was still associated with higher rates of postoperative complications, suggesting that preoperative comorbidities do not influence postoperative outcome. Further prospective studies could be used to validate these results and provide new findings for the management and treatment of these groups.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.8.jns23618","type":"journal-article","created":{"date-parts":[[2023,11,11]],"date-time":"2023-11-11T01:28:04Z","timestamp":1699666084000},"page":"1414-1422","source":"Crossref","is-referenced-by-count":2,"title":["Simultaneous versus staged bilateral carpal tunnel release via open and endoscopic surgeries: a retrospective propensity score\u2013matched patient comorbidity analysis"],"prefix":"10.3171","volume":"140","author":[{"given":"Debarati","family":"Bhanja","sequence":"first","affiliation":[{"name":"Penn State College of Medicine, Hershey, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Freedman","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine, Hershey, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lekhaj","family":"Daggubati","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The George Washington University Hospital, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Moeckel","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine, Hershey, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Rizk","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine, Hershey, Pennsylvania;"},{"name":"Department of Neurosurgery, Penn State College of Medicine, Hershey, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"11","key":"b1","series-title":"Neurology","first-page":"1431","article-title":"Carpal tunnel syndrome: complex issues with a \"simple\" condition","volume":"56","author":"Olney RK","year":"2001","unstructured":"Olney RK. Carpal tunnel syndrome: complex issues with a \"simple\" condition. Neurology. 2001;56(11):1431\u20131432."},{"issue":"1","key":"b2","series-title":"Ortop Traumatol Rehabil","first-page":"1","article-title":"Carpal tunnel syndrome: symptoms, causes and treatment options. Literature reviev","volume":"19","author":"Zamborsky R","year":"2017","unstructured":"Zamborsky R, Kokavec M, Simko L, Bohac M. Carpal tunnel syndrome: symptoms, causes and treatment options. Literature reviev. Ortop Traumatol Rehabil. 2017;19(1):1\u20138."},{"issue":"1","key":"b3","series-title":"Neurosciences (Riyadh)","first-page":"4","article-title":"Pathophysiology of carpal tunnel syndrome","volume":"20","author":"Aboonq MS","year":"2015","unstructured":"Aboonq MS. Pathophysiology of carpal tunnel syndrome. Neurosciences (Riyadh). 2015;20(1):4\u20139."},{"issue":"8","key":"b4","series-title":"Am Fam Physician","first-page":"952","article-title":"Carpal tunnel syndrome","volume":"83","author":"LeBlanc KE","year":"2011","unstructured":"LeBlanc KE, Cestia W. Carpal tunnel syndrome. Am Fam Physician. 2011;83(8):952\u2013958."},{"issue":"3","key":"b5","series-title":"Cureus","first-page":"e7333","article-title":"Carpal tunnel syndrome: a review of literature","volume":"12","author":"Genova A","year":"2020","unstructured":"Genova A, Dix O, Saefan A, Thakur M, Hassan A. Carpal tunnel syndrome: a review of literature. Cureus. 2020;12(3):e7333."},{"issue":"12","key":"b6","series-title":"Lancet Neurol","first-page":"1273","article-title":"Carpal tunnel syndrome: clinical features, diagnosis, and management","volume":"15","author":"Padua L","year":"2016","unstructured":"Padua L, Coraci D, Erra C,  Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016;15(12):1273\u20131284."},{"issue":"5","key":"b7","series-title":"J Bone Joint Surg Br","first-page":"655","article-title":"The carpal tunnel syndrome is a bilateral disorder","volume":"83","author":"Bagatur AE","year":"2001","unstructured":"Bagatur AE, Zorer G. The carpal tunnel syndrome is a bilateral disorder. J Bone Joint Surg Br. 2001;83(5):655\u2013658."},{"issue":"1","key":"b8","series-title":"Lancet Rheumatol","first-page":"e49","article-title":"Serious postoperative complications and reoperation after carpal tunnel decompression surgery in England: a nationwide cohort analysis","volume":"3","author":"Lane JCE","year":"2020","unstructured":"Lane JCE, Craig RS, Rees JL,  Serious postoperative complications and reoperation after carpal tunnel decompression surgery in England: a nationwide cohort analysis. Lancet Rheumatol. 2020;3(1):e49\u2013e57."},{"issue":"8","key":"b9","series-title":"Eur J Orthop Surg Traumatol","first-page":"1253","article-title":"Similar effectiveness of the open versus endoscopic technique for carpal tunnel syndrome: a prospective randomized trial","volume":"25","author":"G\u00fcm\u00fc\u015fta\u015f SA","year":"2015","unstructured":"G\u00fcm\u00fc\u015fta\u015f SA, Ekmek\u00e7i B, Tosun HB, Orak MM, Bekler H\u0130. Similar effectiveness of the open versus endoscopic technique for carpal tunnel syndrome: a prospective randomized trial. Eur J Orthop Surg Traumatol. 2015;25(8):1253\u20131260."},{"issue":"1","key":"b10","series-title":"BMC Musculoskelet Disord","first-page":"65","article-title":"Morphologic change of nerve and symptom relief are similar after mini-incision and endoscopic carpal tunnel release: a randomized trial","volume":"18","author":"Oh WT","year":"2017","unstructured":"Oh WT, Kang HJ, Koh IH, Jang JY, Choi YR. Morphologic change of nerve and symptom relief are similar after mini-incision and endoscopic carpal tunnel release: a randomized trial. BMC Musculoskelet Disord. 2017;18(1):65."},{"issue":"1","key":"b11","series-title":"Indian J Orthop","first-page":"57","article-title":"Endoscopic versus open carpal tunnel release: a short-term comparative study","volume":"41","author":"Malhotra R","year":"2007","unstructured":"Malhotra R, Kiran EK, Dua A, Mallinath SG, Bhan S. Endoscopic versus open carpal tunnel release: a short-term comparative study. Indian J Orthop. 2007;41(1):57\u201361."},{"issue":"4","key":"b12","series-title":"J Hand Surg Am","first-page":"549","article-title":"Symptoms, functional status, and neuromuscular impairment following carpal tunnel release","volume":"20","author":"Katz JN","year":"1995","unstructured":"Katz JN, Fossel KK, Simmons BP, Swartz RA, Fossel AH, Koris MJ. Symptoms, functional status, and neuromuscular impairment following carpal tunnel release. J Hand Surg Am. 1995;20(4):549\u2013555."},{"issue":"6","key":"b13","series-title":"J Plast Surg Hand Surg","first-page":"311","article-title":"Retrospective analysis of 242 patients whose carpal tunnels were released using a one-port endoscopic procedure: superior results of early intervention","volume":"44","author":"Eisenhardt SU","year":"2010","unstructured":"Eisenhardt SU, Mathonia C, Stark GB, Horch RE, Bannasch H. Retrospective analysis of 242 patients whose carpal tunnels were released using a one-port endoscopic procedure: superior results of early intervention. J Plast Surg Hand Surg. 2010;44(6):311\u2013317."},{"issue":"2","key":"b14","series-title":"Plast Reconstr Surg","first-page":"309e","article-title":"Reply: Revision carpal tunnel release: risk factors and rate of secondary surgery","volume":"148","author":"Westenberg RF","year":"2021","unstructured":"Westenberg RF, Eberlin KR, Chen NC. Reply: Revision carpal tunnel release: risk factors and rate of secondary surgery. Plast Reconstr Surg. 2021;148(2):309e\u2013310e."},{"issue":"11","key":"b15","series-title":"J Bone Joint Surg Am","first-page":"889","article-title":"Simultaneous bilateral or unilateral carpal tunnel release? A prospective cohort study of early outcomes and limitations","volume":"96","author":"Osei DA","year":"2014","unstructured":"Osei DA, Calfee RP, Stepan JG, Boyer MI, Goldfarb CA, Gelberman RH. Simultaneous bilateral or unilateral carpal tunnel release? A prospective cohort study of early outcomes and limitations. J Bone Joint Surg Am. 2014;96(11):889\u2013896."},{"issue":"1","key":"b16","series-title":"Plast Reconstr Surg","first-page":"139","article-title":"Staged versus simultaneous bilateral endoscopic carpal tunnel release: an outcome study","volume":"118","author":"Nesbitt KS","year":"2006","unstructured":"Nesbitt KS, Innis PC, Dubin NH, Wilgis EFS. Staged versus simultaneous bilateral endoscopic carpal tunnel release: an outcome study. Plast Reconstr Surg. 2006;118(1):139\u2013147."},{"issue":"6","key":"b17","series-title":"J Hand Surg Eur Vol","first-page":"627","article-title":"A comparison of the functional difficulties in staged and simultaneous open carpal tunnel decompression","volume":"39","author":"Dickson DR","year":"2014","unstructured":"Dickson DR, Boddice T, Collier AM. A comparison of the functional difficulties in staged and simultaneous open carpal tunnel decompression. J Hand Surg Eur Vol. 2014;39(6):627-631."},{"issue":"11","key":"b18","series-title":"J Am Acad Orthop Surg","first-page":"796","article-title":"Simultaneous bilateral versus staged bilateral carpal tunnel release: a cost-effectiveness analysis","volume":"24","author":"Park KW","year":"2016","unstructured":"Park KW, Boyer MI, Gelberman RH, Calfee RP, Stepan JG, Osei DA. Simultaneous bilateral versus staged bilateral carpal tunnel release: a cost-effectiveness analysis. J Am Acad Orthop Surg. 2016;24(11):796\u2013804."},{"issue":"3","key":"b19","series-title":"Hand Surg Rehabil","first-page":"175","article-title":"Bilateral simultaneous endoscopic carpal tunnel release: mean time to resume activities of daily living and return to work","volume":"37","author":"Degeorge B","year":"2018","unstructured":"Degeorge B, Coulomb R, Kouyoumdjian P, Mares O. Bilateral simultaneous endoscopic carpal tunnel release: mean time to resume activities of daily living and return to work. Hand Surg Rehabil. 2018;37(3):175\u2013179."},{"issue":"5","key":"b20","series-title":"J Hand Surg Am","first-page":"845","article-title":"Bilateral simultaneous open carpal tunnel release: a prospective study of postoperative activities of daily living and patient satisfaction","volume":"28","author":"Wang AA","year":"2003","unstructured":"Wang AA, Hutchinson DT, Vanderhooft JE. Bilateral simultaneous open carpal tunnel release: a prospective study of postoperative activities of daily living and patient satisfaction. J Hand Surg Am. 2003;28(5):845\u2013848."},{"issue":"5","key":"b21","series-title":"J Hand Surg Am","first-page":"475.e1","article-title":"Self-reliance and postoperative hand recovery after simultaneous, bilateral endoscopic carpal tunnel release: a prospective study","volume":"47","author":"van Rooij JAF","year":"2022","unstructured":"van Rooij JAF, Fechner MR, van Tits HWHJ, Geerards D. Self-reliance and postoperative hand recovery after simultaneous, bilateral endoscopic carpal tunnel release: a prospective study. J Hand Surg Am. 2022;47(5):475.e1\u2013475.e7."},{"issue":"1","key":"b22","series-title":"J Hand Surg Br","first-page":"9","article-title":"Does endoscopic carpal tunnel release have a higher rate of complications than open carpal tunnel release? An analysis of published series","volume":"24","author":"Boeckstyns ME","year":"1999","unstructured":"Boeckstyns ME, S\u00f8rensen AI. Does endoscopic carpal tunnel release have a higher rate of complications than open carpal tunnel release? An analysis of published series. J Hand Surg Br. 1999;24(1):9\u201315."}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/140\/5\/article-p1414.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/140\/5\/article-p1414.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/140\/5\/article-p1414.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T10:24:19Z","timestamp":1716632659000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/140\/5\/article-p1414.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,1]]},"references-count":22,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2023.8.jns23618","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,1]]}}}