Longitudinal Median Nerve Ultrasound Changes in Individuals With Spinal Cord Injury and an Age- and Sex-Matched Nondisabled Cohort.
Minh Quan T Le, Elizabeth R Felix, Robert Irwin and 2 others
PMID 36545523WHAT IT FOUND
One year after spinal cord injury, patients reported more carpal tunnel symptoms than age-matched controls.
Ultrasound changes in the median nerve were subtle and mostly appeared in the nondominant hand, suggesting monitoring for symptoms rather than relying on imaging alone.
Key findings
01Individuals with SCI had significantly higher physical exam scores for median neuropathy in both the dominant and nondominant arms at 1-year follow-up compared to controls.
02There were no significant differences in median nerve cross-sectional area (CSA) change scores between the SCI and non-SCI groups over the year.
03Participants with a baseline CSA below 10.0 mm2 experienced a greater increase in CSA in the nondominant arm over one year compared to those with a larger baseline nerve.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Small sample size (55 completers) increases the risk of missing real differences (Type II error). The participants were young (median age 28), much younger than the typical onset age for carpal tunnel syndrome (40-60), which may affect generalizability. Demographic differences existed between groups, with the SCI group having a higher proportion of African American participants and higher body weight. The study followed participants for only one year; longer duration may be needed to see structural nerve changes.
The easy way to misread this
Do not assume that a lack of significant ultrasound changes (CSA) in the SCI group means the median nerve is unaffected. The physical exam scores for neuropathy were significantly worse in the SCI group at one year, indicating that clinical symptoms may precede or occur independently of measurable structural enlargement in this timeframe.