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Endoscopic Cubital Tunnel Release

Don’t know what Ulnar Neuropathy is? No problem! Read more about the causes and symptoms of ulnar neuropathy

Non-Surgical Ulnar Neuropathy Treatments

Conservative treatments can help, but often do not resolve this problem entirely. Such treatments can include rest, anti-inflammatories, occupational therapy, splints for the wrist or elbow, and sometimes steroid injections. Changing the way you position your elbows at the computer or while driving may also help (put less pressure on the elbows).

It is dangerous to inject a nerve that is compressed in a tight space for two reasons: you can add more pressure on the nerve, and you can accidentally inject it into the nerve causing damage. Diabetic patients should also be cautious about steroid injections as it could transiently elevate blood sugar levels.

Surgical Options for Ulnar Neuropathy

There are several generally accepted surgical techniques available for the ulnar nerve surgery at the elbow.

The open technique – this is called an open technique because an incision is usually made the entire length of the nerve around the elbow in order to expose it. Incisions can be sometimes 6 inches or larger. Once the nerve is “decompressed” then the surgeon can either leave the nerve in its native position or transpose it (move it) to new location with there is less tension or compression on it. Some surgeons will create a pocket from the fatty tissue under the skin to create a nice soft bed for the nerve to sit in (subcutaneous transposition), and others will place it underneath a muscle for protection (sub-muscular transposition).

Minimally Invasive Surgical Options for Ulnar Neuropathy

The minimally invasive endoscopic ulnar nerve decompression achieves the same goal as the open technique, but with a much smaller incision. This is because the surgery is aided with high-tech HD endoscopic equipment, so the incisions can be smaller and less invasive. Studies have shown that this technique with leaving the nerve in the native position is equally effective in treating ulnar neuropathy as the open technique. Not all physicians have the experience to perform such a technique. Sometimes it is not possible to perform the endoscopic cubital tunnel release, and sometimes the ulnar neuropathy may be too advanced for just a decompression. In this case one may consider a transposition in conjunction with the endoscopic ulnar nerve decompression.

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