Double crush syndrome: Epidemiology, diagnosis, and treatment results

Neurochirurgie. 2021 Apr;67(2):165-169. doi: 10.1016/j.neuchi.2020.09.011. Epub 2020 Oct 29.

Abstract

Background: Double Crush Syndrome (DCS) is a clinical condition that involves multiple compression sites along a single peripheral nerve. The present study aims to describe the epidemiology of DCS and surgical results.

Methods: A retrospective observational analytic study included patients with clinical diagnosis of cervical radiculopathy and carpal tunnel syndrome who underwent surgery between January 2009 and January 2019. General demographic characteristics were noted, and 3 groups were distinguished: spinal surgery, carpal tunnel release, and bimodal decompression (BD); statistical differences were analyzed between them.

Results: The sample comprised 32 patients. DCS prevalence was 10.29%. Mean age at presentation was 59.25±10.98 years. There was female predominance (75%). Paresthesia was the main symptom (65.6%). Post-surgical results of BD showed significant improvement in sensory nerve conduction velocity, motor nerve conduction velocity (both P=0.008), and disability on Douleur Neuropathique 4 questions, Neck Disability Index, and Boston Carpal Tunnel Questionnaire (P=0.001, 0.004, 0.008, respectively).

Conclusions: Diagnosis and management of DCS are a challenge. It is necessary to determine the site with maximal compression and risk of complications to decide on treatment. If first-line surgery is adequate, proximal and distal symptomatology can be improved. To maximize success, we recommend BD, according to the present results.

Keywords: Carpal tunnel syndrome; Cervical radiculopathy; Double crush syndrome; Neuropathy.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carpal Tunnel Syndrome / diagnosis
  • Carpal Tunnel Syndrome / epidemiology*
  • Carpal Tunnel Syndrome / surgery*
  • Crush Syndrome / diagnosis
  • Crush Syndrome / epidemiology*
  • Crush Syndrome / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures / methods
  • Neurosurgical Procedures / trends
  • Radiculopathy / diagnosis
  • Radiculopathy / epidemiology*
  • Radiculopathy / surgery*
  • Retrospective Studies
  • Treatment Outcome