Ultrasound guided minimally invasive surgery in entrapment neuropathies

Informational seminar

Entrapment neuropathies are among the most common disorders of the peripheral nervous system and result from focal compression or irritation of a nerve as it passes through anatomically constrained regions. Carpal tunnel syndrome and ulnar neuropathy at the elbow are the most frequent compression neuropathies, presenting with typical symptoms such as pain, paresthesia, sensory loss, and motor dysfunction.

High-resolution neuromuscular ultrasound has become an essential complementary modality in the assessment of entrapment neuropathies. It allows for dynamic, real-time visualization of peripheral nerves, their surrounding anatomical structures, and potential causes of compression, including ganglion cysts, tumors, vascular abnormalities, osteophytes, anomalous muscles, and postoperative changes. Ultrasound also demonstrates characteristic morphological alterations of the affected nerve, such as focal enlargement of the cross-sectional area, altered fascicular architecture, and changes in echogenicity. Crucially, its dynamic nature enables the assessment of nerve mobility and its relationship with adjacent structures during limb movement.

Beyond diagnosis, ultrasound has transformed imaging from a purely diagnostic tool into a guide for interventions and, notably, minimally invasive surgery. Ultrasound guidance permits precise visualization of the needle throughout the procedure, enabling the accurate delivery of therapeutic agents around the affected nerve while minimizing risk to the nerve, vessels, and adjacent structures. It also facilitates minimally invasive release procedures through real-time visualization of the hook knife throughout the intervention. These minimally invasive surgical techniques are a game changer, particularly in hand surgery, requiring only a single tiny incision proximal to the carpal crease compared to traditional open surgery. Reduced soft tissue trauma, the elimination of sutures, minimal scar formation, and a faster return to work are among the primary advantages.

In this one-day seminar, you will have the opportunity to explore the value of ultrasound in diagnosing the most common compression neuropathies and discover the potential of minimally invasive surgery, complete with step-by-step instructions on how to perform the procedure safely.