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Abstract：
Background The relationship between tarsal tunnel syndrome (TTS), electrodiagnostic (Edx) findings, and surgical outcome is unknown. Analysis of TTS surgical release outcome patient satisfaction and comparison to Edx nerve conduction studies (NCSs) is important to improve outcome prediction when deciding who would benefit from TTS release. Methods Retrospective study of 90 patients over 7 years that had tarsal tunnel (TT) release surgery with outcome rating and preoperative tibial NCS. Overall, 64 patients met study inclusion criteria with enough NCS data to be classified into one of the following three groups: (1) probable TTS, (2) peripheral polyneuropathy, or (3) normal. Most patients had preoperative clinical provocative testing including diagnostic tibial nerve injection, tibial Phalen\'s sign, and/or Tinel\'s sign and complaints of plantar tibial neuropathic symptoms. Outcome measure was percentage of patient improvement report at surgical follow-up visit. Results Patient-reported improvement was 92% in the probable TTS group ( n = 41) and 77% of the non-TTS group ( n = 23). Multivariate modeling revealed that three out of eight variables predicted improvement from surgical release, NCS consistent with TTS ( p = 0.04), neuropathic symptoms ( p = 0.045), and absent Phalen\'s test ( p = 0.001). The R 2 was 0.21 which is a robust result for this outcome measurement process. Conclusion The best predictors of improvement in patients with TTS release were found in patients that had preoperative Edx evidence of tibial neuropathy in the TT and tibial nerve plantar symptoms. Determining what factors predict surgical outcome will require prospective evaluation and evaluation of patients with other nonsurgical modalities.
摘要：
研究背景与tal管综合征（TTS），电诊断（Edx）发现，手术结果未知。TTS手术释放结果患者满意度的分析以及与Edx神经传导研究（NCSs）的比较对于确定谁将从TTS释放中受益时改善结果预测非常重要。方法回顾性研究90例7年以上接受tal骨隧道（TT）松解术的患者，并进行结果评分和术前胫骨NCS。总的来说,64例患者符合研究纳入标准，具有足够的NCS数据，可分为以下三组之一：（1）可能的TTS，（2）周围性多发性神经病，或者（3）正常。大多数患者术前进行了临床挑衅性测试，包括诊断胫神经注射，胫骨Phalen的标志,和/或Tinel的体征和足底胫骨神经性症状的投诉。结果测量是手术随访时患者改善报告的百分比。结果患者报告的改善在可能的TTS组（n=41）为92％，在非TTS组（n=23）为77％。多变量模型显示，八个变量中有三个预测手术释放的改善，NCS与TTS一致（p=0.04），神经性症状（p=0.045），并且没有Phalen's检验（p=0.001）。R2为0.21，这对于此结果测量过程是一个可靠的结果。结论术前有Edx证据的TT和胫神经足底症状的患者发现TTS松解术改善的最佳预测因子。确定哪些因素可以预测手术结果需要前瞻性评估和其他非手术方式的患者评估。
