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UW Medicine Neurological Surgery in Seattle, Washington, is an international leader in the care and treatment of patients with diseases and disorders of the brain, spine and peripheral nerves. Our providers  specialize in the management of acute brain or spinal trauma, vascular disease, disorders of the brain, peripheral nerves and spine.

We are located in Seattle, Washington and our UW physicians, who practice at Harborview Medical Center, UW Medical Center, Children's Hospital and Regional Medical Center, use state-of-the art technology to ensure patients receive uncompromised care and access to the most advanced facilities and modern resources.

In addition, our well established NIH and privately funded research programs allow us to bring leading-edge advances in neurosurgery from the laboratory to the clinic and operating room.

For information about our clinical trials, conferences, residencies and fellowships, visit the Department of Neurological Surgery's website.


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Featured Article
CTS Release Surgery
Providers: Kliot, Michel W. Last Updated: Tuesday, October 30, 2007

Carpal tunnel syndrome (CTS) is a common condition affecting the hands, wrists, arms, and including the neck region of many patients. Swelling, injury or pressure within the tunnel impacts the median nerve (the nerve in the forearm), resulting in pain or discomfort. Therefore, surgery to correct CTS focuses on reducing pressure on the median nerve.

Diagnosing Carpal Tunnel Syndrome

The most important goal of the diagnostic and imaging exams is to diagnose the carpal tunnel syndrome (CTS) itself. There are conditions such as pregnancy, arthritis, thyroid disease, or diabetes, which can cause symptoms similar to CTS.

As part of the diagnostic process, your doctor will likely perform a full range of diagnostic tests for CTS and the appropriate imaging studies (X-rays, MRI). The doctor will also do a full physical exam, looking closely at the wrist area for pain or swelling.

The main purpose of surgery for CTS is to “release” the band of tissue, known as the transverse carpal ligament, surrounding the median nerve. The transverse carpal ligament acts like a rubber band holding around the tendons of the arm and hand as well as the median nerve. If there is swelling within the carpal tunnel, the transverse carpal tunnel ligament tightens, putting pressure on the median nerve and causing pain. The surgery is therefore called “release” surgery because by cutting the transverse carpal tunnel ligament, it can help release pressure on the median nerve.

Surgery may be an option for patients whose pain or discomfort from CTS has lasted several months, even up to a year. Surgery will be considered for those patients in whom conservative (non-surgical) therapies have not been effective or are unable to provide long-term relief. Non-surgical options for CTS may include: 
  • The use of a splint or wrist brace 
  • Activity modification 
  • Medical management, such as through the use of non-steroidal anti-inflammatory drugs (NSAIDs) 
  • Physical therapy 
  • Steroid injections

The difference between conservative and surgical methods is that while conservative methods may reduce the symptoms associated with CTS, surgery can help treat the underlying cause of CTS: pressure on the median nerve.

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