From deficit to recovery: postoperative neurological improvements in patients with severe cubital tunnel syndrome.

Introduction: Cubital tunnel syndrome (CuTS) is a prevalent focal neuropathy causing motor and sensory deficits in the hand. Some patients present with marked muscle atrophy and impaired hand function, indicating significant nerve damage. Research question: The aim of this prospective study was to ascertain the long-term benefits of surgical intervention for these patients. Material and methods: Patients diagnosed with CuTS who underwent surgical treatment in the authors' department between January 2018 and December 2021 were screened. Patients with visible muscle atrophy and severe hand weakness, classified as grade IIb or III according to the modified McGowan classification, were included within this prospective study. A comprehensive data set was collected and analysed, encompassing clinical data, demographics, high-resolution ultrasound examinations and electrophysiological examinations. These were collected and analysed preoperatively, postoperatively, and at six and twelve months after surgery. Results: A total of 40 patients (26 male (65%), mean age: 55.02 ± 1.88 years) were successfully enrolled in the study. Of those, 18 patients (45%) underwent endoscopically assisted in situ decompression, while open decompression and transposition were performed in the remaining 22 individuals (55%). Neurologically, 24 patients (58.54%) were classified as grade IIb. Postoperative hand power significantly improved (p < 0.001) at six and twelve months after surgery. Neurological improvement based on modified McGowan classification was also significant six (p = 0.016) and twelve months (p = 0.002) after surgery. Discussion and conclusion: Patients with severe CuTS neurologically recover after decompression. Therefore, surgical therapy could be offered to those patients.