The cubital tunnel syndrome: diagnosis and precise localization.

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Abstract

[Indexed for MEDLINE] 17. Neurosurgery. 2024 Nov 1;95(5):1055-1063. doi: 10.1227/neu.0000000000002975. Epub 2024 May 3. Cubital Tunnel Syndrome Due to Intraneural Ganglion Cysts of the Ulnar Nerve With Joint-Cyst Connection at the Elbow. Li H(1), Gao L(2), Qi H(3), Guan S(1). Author information: (1)Department of Hand and Foot Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan , China. (2)Department of Hand and Foot Surgery, The Fourth People's Hospital of Jinan, Jinan , China. (3)Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan , China. BACKGROUND AND OBJECTIVES: The unifying articular theory suggests that intraneural ganglion cysts in the cubital tunnel arise from the elbow joint and are connected to the ulnar nerve through an articular branch. This study aimed to report our clinical experience with these cysts and our surgical findings and outcomes. METHODS: We retrospectively analyzed 13 patients who underwent surgery for cubital tunnel syndrome caused by an intraneural ganglion cyst of the ulnar nerve. Clinical symptoms, physical examination findings, nerve conduction testing electromyography, plain radiography, and ultrasonography were evaluated before and after surgery. MRI was performed in 2 patients. Cyst decompression, disconnection of the articular branch, and ulnar nerve transposition were performed in all. RESULTS: The mean follow-up was 29 months. After surgery, local elbow pain and Tinel sign disappeared in all patients, and the average Numerical Rating Scale dropped from 3.7 (2-5) to 0 (0-0). Two-point discrimination testing was normal (