Two novel nonsurgical treatments of carpal tunnel syndrome.

This article describes 2 nonsurgical approaches to the treatment of carpal tunnel syndrome that are not routinely offered, probably due to a lack of awareness. Osteopathic manipulative treatment (OMT) is commonly used for many medical problems, including musculoskeletal issues. OMT of the carpal tunnel is well described and researched, and can be clinically used by a skilled practitioner. The second treatment strategy is a more recent development. The use of ultrasound for guidance of injection is established, but a newer technique using sonographically guided percutaneous needle release of the transverse carpal ligament has shown promising results.

Normalization of central cord syndrome spinal cord injury urodynamics after intrathecal baclofen therapy: a case report.

Objective. To report a case of improved urodynamics in a central cord syndrome spinal cord injury after intrathecal baclofen therapy. Methods. A 47-year-old man fell resulting in C4-C5 disc herniation with ventral spinal cord compression and cord edema. Results. He underwent an anterior cervical discectomy and fusion. Postoperatively, his examination revealed a C4 ASIA D injury in a central cord syndrome pattern. Cystometrogram (CMG) revealed a hyperactive detrusor with sphincter dyssynergia managed with intermittent self-catheterization. One and a half years later, he was impaired by severe lower limb spasticity, despite oral medications and botulinum toxin injections. After intrathecal pump therapy, CMG revealed relatively normal detrusor and minimal sphincter tone. He volitionally voids with urgency but improved continence, which was maintained in one-year follow-up. Conclusion. Although the main indication for intrathecal baclofen therapy is spasticity, improved urodynamics can be an additional benefit in central cord syndrome spinal cord injury.