Objective: To determine the outcome of microscopic carpal tunnel release in patients with carpal tunnel syndrome who failed to respond to conservative treatment.

Material and Methods: This descriptive case series was carried at Department of Neurosurgery, Sheikh Zayed Hospital Rahim Yar Khan over 1 year from Jan 2018 to Dec 2018, involving 100 patients; both men and women with ages in the range 30-70 years diagnosed of carpal tunnel syndrome who failed to respond to conservative treatment and were planned for surgical release. Microscopic CTS release was performed and outcomes were assessed in terms of improvement in VAS score for wrist pain, symptom severity score and function status scale 3 and 6 months after the surgery. Recurrence of symptoms was also noted. A written informed consent was obtained from every patient.

Results: The mean age of the patients with carpal tunnel syndrome was 45.6±7.9 years. There was slight female predominance with male to female ratio of 1:2.1. History of diabetes was recorded in 31 (31.0%) patients while 37 (37.0%) patients were obese. Right hand was more frequently involved (53.0%) than the left hand (47.0%). The mean VAS score for wrist pain reduced from 7.9±1.2 at baseline to 1.8±0.7 3 months after the surgery (p-value<0.001). Similar improvements were also noted in symptom severity score (3.8±0.8 to 1.6±0.8; p-value<0.001) and function status scale (2.7±0.8 to 1.5±0.8; p-value<0.001) at the end of 3 months after the surgery. Recurrence was not observed in any patient at the end of 6 months follow-up.

Conclusion: Microscopic carpal tunnel release was found to relieve patient’s symptoms and improve wrist function yet with minimal scarring and without recurrence which advocates its preferred use in future practice provided necessary surgical skills and hardware are available.