• Syed I Khalid, Daniel Deysher, Kyle Thomson, Harsh Khilwani, Pranav Mirpuri, Marquis Maynard, Owoicho Adogwa, and Ankit I Mehta.
• Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA. Electronic address: syed.khalid@me.com.
• World Neurosurg. 2023 Mar 1; 171: e162e171e162-e171.

ObjectiveCarpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the world. Surgical treatment can be performed in an open or endoscopic fashion. To date, similar rates of complications for both approaches have been described. We sought to compare the results of endoscopic carpal tunnel release (ECTR) with open carpal tunnel release (OCTR) in patients with CTS.MethodsPatients with a diagnosis of CTS undergoing open or endoscopic surgical management were identified between January 2010 and October 2020. The primary outcome of the study was nerve injury within 30 days of the procedure. Secondary outcomes included readmission, wound-related complications, hematoma, seroma formation, and cost.ResultsA total of 735,631 patients were identified as undergoing CTR. Following a 1:1 match procedure, 292,626 patient records were analyzed. Patients undergoing OCTR versus ECTR had an increased odds of readmission at 30 days (odds ratio [OR] 1.89, 95% confidence interval [CI] 1.73-2.06), developing an infection (OR 1.59, 95% CI 1.41-1.80), and experiencing wound complications (OR 1.97, 95% CI 1.74-2.23). No significant difference in odds of developing a seroma (OR 1.17, 95% CI 0.83-1.65), hematoma (OR 1.15, 95% CI 0.95-1.39), or nerve injury (OR 1.18, 95% CI 0.98-1.43) was noted. The reimbursement cost of ECTR was significantly greater than OCTR ($310.60 ± $1639.57 vs. $237.69 ± $1488.93, P < 0.001).ConclusionsIn the largest study to date on the surgical management of CTR, OCTR was seen to be associated with an increased odds of readmission, infection, and wound complications, but reduced costs for the procedure alone.Copyright © 2022 Elsevier Inc. All rights reserved.

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