Smith, Brandon J.

Background: Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome. The thread carpal tunnel release (TCTR) is an incision-less ultrasound-guided approach to divide the transverse carpal ligament. This retrospective case series aims to identify and assess the bleeding risks associated with continuing anticoagulation or antiplatelet therapy during TCTR. Methods: Retrospective chart review with follow-up questionnaires/surveys. One hundred and fourteen adult patients who were using antiplatelet or anticoagulation medication underwent 164 TCTR procedures during 2018 to 2023 at a single institution (tertiary care hospital) from June 29, 2018, and August 11, 2023. A chart review was performed to identify patients on antiplatelets or anticoagulants at the time of the procedure and to determine if there were any adverse events associated with continuing or holding their antiplatelet or anticoagulant therapy. Results: There were no significant complications associated with continuing or holding anticoagulation or antiplatelet therapy during TCTR. Conclusions: Continuing antiplatelet therapy during TCTR appears safe. The decision to continue antiplatelet or anticoagulation therapy should be made on a case-by-case basis.

This case series aims to highlight the efficacy of peripheral nerve stimulation (PNS) in the treatment of phantom limb pain, as well as provide an alternative method for the treatment of this pain syndrome. In this report, we describe three amputee patients with severe phantom limb pain who obtained substantial analgesia and improvement in physical functionality after implantation of a temporary PNS device. Future studies should assess predictors of successful response or poor response to PNS therapy, such as mental health, environmental stressors, coping skills, and procedural factors. These factors may facilitate an individualized approach for each patient to ensure appropriate candidacy for PNS and better prognosis. Considering that patients in our cohort did not achieve long-lasting benefit after removal of temporary PNS, future research should assess if patients with phantom limb pain would benefit from permanent PNS, rather than temporary PNS.