Evidence map›Paper›PMID 42756968›Full record

ReviewJPRAS open2026

Minimally invasive vs standard open carpal tunnel release: A systematic review, meta-analysis, and trial sequential analysis of randomized controlled trials.

Ahmed Khaled Almarri, Yazan J Alalwani, Ammar Alsayegh, Mohammed Khder M Alamri, Faisal Falah Alanazi, Abdulmalik Hadi AlEnazy, Daniyah Adil A Alharbi, Nawaf Salman Almutairi, Ghayed Ahmad AlWassiah, Anna Abdulmohsen Almutlaq and 5 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Ahmed Khaled AlmarriOrthopedic Surgery Resident, Department of Orthopedic Surgery, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
Yazan J AlalwaniCollege of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
Ammar AlsayeghCollege of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
Mohammed Khder M AlamriDepartment of Orthopedic Surgery, East Jeddah General Hospital, Jeddah, Saudi Arabia.
Faisal Falah AlanaziCollege of Medicine, Sulaiman AlRajhi University, Bukayriyah, Saudi Arabia.
Abdulmalik Hadi AlEnazyCollege of Medicine, Sulaiman AlRajhi University, Bukayriyah, Saudi Arabia.
Daniyah Adil A AlharbiCollege of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
Nawaf Salman AlmutairiCollege of Medicine, University of Jeddah, Jeddah, Saudi Arabia.
Ghayed Ahmad AlWassiahCollege of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Anna Abdulmohsen AlmutlaqCollege of Medicine, Qassim University, Qassim, Saudi Arabia.
Abdulmajeed Abdulaziz AlfouzanCollege of Medicine, Qassim University, Qassim, Saudi Arabia.
Fadi Ibrahim AlhobayyebCollege of Medicine, Qassim University, Qassim, Saudi Arabia.
Raneem M TurkistaniPlastic and Reconstructive Surgery, King Abdulaziz Medical City, NGHA, Jeddah, Saudi Arabia.
Abdulaziz Ibrahim AlzahraniOrthopedic Department, Buraydah Central Hospital, Qassim Cluster, Saudi Arabia.
Ahmed Y AzzamDivision of Global Health and Public Health, School of Nursing, Midwifery and Public Health, University of Suffolk, Ipswich, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment disorder around the world. Minimally invasive carpal tunnel release (MI-OCTR) techniques have been developed as alternatives to standard open CTR; however, the evidence comparing these approaches remains inconclusive. Our study aimed to evaluate the efficacy, safety, and perioperative outcomes of MI-OCTR versus standard open CTR. Methods: Following PRISMA 2020 guidelines, PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar were searched from inception through 20 December 2025. Randomized controlled trials (RCTs) comparing MI-OCTR with standard open CTR were included. Random-effects meta-analysis with Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment and trial sequential analysis (TSA) were performed. Results: Ten RCTs (660 randomized units) were included. No significant differences were observed for Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS), (mean difference [MD] = -0.36, 95% confidence interval [CI]: -1.07 to 0.35, P-value = 0.23, I² = 98.2%) or Functional Status Scale (MD = -0.27, 95% CI: -0.75 to 0.21, P-value = 0.19). MI-OCTR demonstrated significantly shorter incision length (MD = -2.00 cm, P-value = 0.04) and earlier return to work (MD = -9.66 days, P-value = 0.02). TSA confirmed that only 1.2% of the required information size for BCTQ-SSS had been accrued, indicating the evidence remains inconclusive. Conclusions: MI-OCTR and standard open CTR demonstrated similar efficacy in symptom relief, with MI-OCTR offering possible perioperative advantages. The certainty of evidence was very low for most outcomes, and TSA indicated that significantly larger trials are needed to reach definitive conclusions.

Indexed as

Carpal tunnel releaseCarpal tunnel syndromeMedian nerveMinimally invasive surgeryTrial sequential analysis

Identifiers

PMID42756968
PMCPMC13584054

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.