Enhancing Recovery After Endoscopic Carpal Tunnel Release: The Role of Neurotrophic Supplementation

Background: – This study assesses the role of neurotrophic supplementation on clinical and neurophysiological recovery in patients undergoing endoscopic carpal tunnel release (ECTR) for severe carpal tunnel syndrome (CTS). Methods: – A total of 291 patients with severe CTS (visual analog scale [VAS] nocturnal pain ≥7, VAS function ≤ 4, and sensory conduction velocity [SCV] < 35 m/s) were retrospectively analyzed. Patients treated after March 2023 received neurotrophic supplementation for 6 months (E + N group, n = 172); those treated previously received ECTR alone (E group, n = 119). SCV and VAS scores were assessed at baseline and at 1, 3, 6, and 12 months. Upper limb disability was additionally evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire at the same time points. Statistical comparisons were performed using post hoc Tukey tests and χ2 tests. Results: – The E + N group showed improvement in SCV and VAS scores at 1 and 3 months (P < 0.05). A faster improvement in DASH score was also observed in the E + N group during the early postoperative period, with a 44% reduction at 3 months compared with 37% in the E group (P < 0.05). At 6 and 12 months, both groups had comparable outcomes. Complication rates were low and not significantly different between groups. Conclusions: – Neurotrophic supplementation after ECTR accelerates early functional and electrophysiological recovery in severe CTS without increasing complications. Although long-term outcomes are similar, early recovery advantages support its use in selected patients.