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All Journal Indonesian Journal of Global Health research Glosains: Jurnal Sains Global Indonesia
Made Bramantya Karna
Universitas Udayana
Education Health Professions Languange, Linguistic, Communication & Media Nursing Public Health

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Comparison of Clinical and Electromyographic Outcomes of Amnion–Methylcobalamin in Carpal Tunnel Release Made Bramantya Karna; I Ketut Suyasa; Gede Aditya Krisna; Komang Arimbawa; Ni Made Dwita Pratiwi
Glosains: Jurnal Sains Global Indonesia Vol. 7 No. 2 (2026): Glosains: Jurnal Sains Global Indonesia
Publisher : Sekolah Tinggi Agama Islam Kuningan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59784/glosains.v7i2.747

Abstract

Background: Carpal tunnel syndrome (CTS) commonly requires carpal tunnel release (CTR); however, residual symptoms and incomplete nerve recovery remain unresolved. Amniotic membrane and methylcobalamin have individually demonstrated anti-inflammatory, neuroregenerative, and remyelinating effects, but their combined use as an adjuvant during CTR has not been evaluated. Objective: To compare clinical and electromyographic (EMG) outcomes between standard carpal tunnel release (CTR) alone and CTR combined with amniotic membrane and methylcobalamin in patients with CTS. Methods: A nonrandomized controlled trial conducted at Prof. Dr. I.G.N.G. Ngoerah General Hospital (January–March 2025) involving 24 CTS patients allocated to CTR alone (control, n = 12) or CTR with amniotic membrane impregnated with a methylcobalamin solution (treatment, n = 12). EMG parameters (distal motor latency, amplitude, and conduction velocity) and the Liverpool Carpal Tunnel Scoring System (LCTSS) were measured preoperatively and 4 weeks postoperatively. Paired t-tests and Wilcoxon signed-rank tests were applied (α = 0.05). Results: Both groups showed significant postoperative EMG improvement (p < 0.001). The treatment group achieved greater gains in conduction velocity (Δ = +6.48 m/s vs +4.58 m/s) and SNAP amplitude (Δ = +7.44 µV vs +4.55 µV). LCTSS improved in both groups; however, the within-group difference for the treatment arm did not reach statistical significance at 4 weeks (p = 0.083). No complications were observed. Conclusion: Combining amniotic membrane and methylcobalamin with CTR accelerates electrophysiologic recovery, although the 4-week clinical advantage was not statistically significant. This combination may benefit patients with severe or recurrent CTS; however, larger randomized controlled trials with 6–12-month follow-up are warranted.
Comparison of Platelet-Rich Plasma with Corticosteroid Injections for Patients with Mild to Moderate Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis of Current Evidence in Randomized Controlled Trials I Made Wira Kusuma; Made Bramantya Karna; Anak Agung Gde Yuda Asmara; Stedi Adnyana Christian
Indonesian Journal of Global Health Research Vol 6 No S6 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6iS6.4580

Abstract

Carpal tunnel syndrome (CTS) accounts for over 90% of peripheral entrapment neuropathy cases. Platelet-rich plasma (PRP), has shown promise due to its anti-inflammatory effects and potential to support axonal repair and neuronal regeneration. The aim of this study is to evaluate the comparative therapeutic efficacy of PRP and corticosteroid injections in treating mild to severe CTS, using a three-month follow-up period.Methods: This meta-analysis followed the PRISMA framework, reviewing studies from 2017 to 2022 in PubMed and the Cochrane Library that compare PRP and corticosteroid injections for CTS. Primary outcome including Visual Analog Scale (VAS), Sensory Peak Latency (SPL), Distal Motor Latency (DML), and the Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS). Results: Four studies remained after matches the screening phase. This meta-analysis includes 245 patients, including 123 receiving PRP and 122 corticosteroid injections. When looking at the VAS 1 and 3 month periods, FSS 3 months, SSS 3 months, DML 1 and 3 months, and SPL 3 months, there were statistically significant changes better outcomes towards PRP injection group compared to the control group. Conclusion: PRP injections provided better short- to mid-term relief and improved electrophysiological outcomes compared to corticosteroid injections in mild to moderate CTS cases.
Co-Authors Anak Agung Gde Yuda Asmara Gede Aditya Krisna I Ketut Suyasa I Made Wira Kusuma Komang Arimbawa Ni Made Dwita Pratiwi Stedi Adnyana Christian