The present study was carried out in accordance with the current Helsinki Convention of the World Medical Association. Aproval of all of the patients was obtained to use their medical records in retrospective file scanning. Our study population is composed of patients who are referred with suspicion of CTS. A total of 1150 patients were evaluated. Four hundred and fifty female patients ( 150 primara, 150 multipara and 150 grand multipara women ) referred to the electrophsiology laboratory with clinical suspicion CTS were included into the descriptive and retrospective study between November 2016 and June 2018. Demographic data included age, BMI and delvery number of the participants ( Table 1 ). Also BMI was calculated for each patient and it compared among groups. Primiparity, multiparity and grand multiparity were defined as women having 1, 2 – 5 and 6 - 9 deliveries, respectively. Patients who passed 2 years after their last birth were included in the study. EMG results were obtained from the computer records and the electrophysiological reports on the CD of the participants evaluated by the researcher. Exclusion criteria in this study are cervical radiculopathy or plexopathy, hypertension, dyslipidemia, chronic renal failure, gout, wrist fracture, malignancy, patients receiving chemotherapy and or radiotherapy, those with clinical and electrophysiological polyneuropathy, those with rheumatologic and thyroid diseases, pregnant women, and those with severe upper extremity trauma history and or any other disease resulting in CTS. All of the patients were assessed and compared in terms of electrophysiological CTS presence and degree of CTS.
The Electrodiagnostic test ( EDT ) studies
Electrophysiological evaluation was done with Nihon Cohden (Tokyo, Japan) electromyograph (EMG). Both patient’s and room temperature were monitored so as not to affect the recording procedures, and the patient’s skin was cleaned with alcohol 70 % to decrease its resistance. The study was carried out with surface electrodes, using standard nerve conduction techniques in accordance with the protocol proposed by the American Electrodiagnostic Medicine Association (9). Patients of whom the both upper extremities were examined included in the study, median and ulnar nerve conduction in one extremity was performed, while only median nerve conduction study in the other extremity was performed. The median motor nerve conduction was recorded using standard techniques through ulation of the surface of the abductor pollicis brevis muscle located in the center of the muscle and wrist and antecubital fossa. For median nerve (8 cm) stimulation the upper limit of the motor distal latency was 4 ms and the lower of the transmission rate was 50 m/sec. The sensory neurotransmission study was performed on the second finger and the mixed nerve conduction study was performed from the palm of the hand, recorded orthodromatically from the wrist. The distance between the recording and the stimulator was 12-14 cm, the upper limit of sensory neural action potential (DSAP) peak latency difference was 0.5 ms, and the median sensory nerve conduction velocity at the wrist level was 50 m/sec. In order to exclude cervical radiculopathy, upper extremity needle ENMG studies were conducted when needed. Patients were divided into three groups by electrophysiological evaluation as described in the literatüre ( 10, 11 ). CTS severities in primipara, multipara and grand multipara women were given in Table 2. ( Table 2 ).
Statistical analyses
Statistical analyses were be performed using SPSS 20.0 (Statistical Package for Social Sciences version 20, IBM, Chicago, Illinois, USA). Data were be presented as mean scores ± SD for categorical data. The variables age, parity and BMI were used in all the patients. Chi - square test, Kruskal-Wallis H test and Mann-Whitney U test was used for statistical analysis. Significance level was accepted as p ≤ 0.05.