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Cubital Tunnel Syndrome Surgery

Cubital Tunnel Release Procedure

What Is the Cubital Tunnel Syndrome?

Cubital Tunnel Syndrome, a compressive neuropathy of the ulnar nerve at the elbow, is the second most common compressive neuropathy in upper extremities (1st = carpal tunnel syndrome). To understand how peripheral nerves get injured, read this blog: https://centenoschultz.com/nerve-hydrodissection/

The Ulnar nerve is a continuation of nerve roots from your middle and lower neck (cervical spine) that get combined in the upper arm and then travel down the inside of your arm. It enters the cubital tunnel on the inside of your elbow and then travels to your hand. 

How Successful Is Cubital Tunnel Surgery?

In recent years, physicians have been favoring surgery. In a study by Osei et al., 41.3% of patients diagnosed with cubital tunnel syndrome were eventually treated surgically in their study period of 6 years. BUT does the level of evidence favor the need for such high surgical conversion rates? (Osei)

The amount of Cubital Tunnel Surgery research has increased but very few high-level studies even exist to confirm the safety and efficacy of surgery.  A 2019 meta-analysis demonstrated that “[t]he current body of evidence regarding Cubital Tunnel Syndrome lacks prospective, randomized, controlled trials, uniform reporting of indications, and standardized outcome scoring” (Said).

rise in reported cubital tunnel syndrome since 1990

Revision rates for persistent or recurrent Cubital Tunnel Syndrome are at around 19% (almost 2 out of 10 patients need another surgery!). Common causes for failure include the incomplete release of the entrapment and postoperative perineural scarring (avache). The most common finding in revision surgery was perineural scarring (79%), with the most frequent entrapment site being the medial intermuscular septum (33%) (kho).  Studies also show that the outcome of revision surgery is less favorable than after primary surgery and complete resolution of symptoms is unlikely.

To get surgery or not? Functional outcomes were averagely reported and varied widely. A consensus regarding the functional outcome parameters after surgery for Cubital Tunnel Syndrome is urgently needed.

The Future: Non-Surgical Alternatives

We continue to push the boundaries of interventional procedures utilizing the most advanced regenerative ortho-biologics to allow natural healing of the nerve while hydrodissecting, percutaneously decompressing without the need for surgery! If you’d like to find out if you’re a candidate for our advanced peripheral nerve injury treatment, feel free to contact us today for a full evaluation.    

Doctors Who Help Patients Avoid Cubital Tunnel Syndrome Surgery

Also Known as Cubital Tunnel Release Procedure

Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

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John Schultz, MD

My passion and specialization are in the evaluation and treatment of cervical disc, facet, ligament and nerve pain, including the non-surgical treatment of Craniocervical instability (CCI). I quit a successful career in anesthesia and traditional pain management to pursue and advance the use of PRP and bone marrow concentrate for common orthopedic conditions. I have been a patient with severe pain and know firsthand the limitations of traditional orthopedic surgery. I am a co-founder of the Centeno-Schultz Clinic which was established in 2005. Being active is a central part of my life as I enjoy time skiing, biking, hiking, sailing with my family and 9 grandchildren.

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John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

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Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

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Matthew William Hyzy, D.O.

Doctor Hyzy is Board Certified in Physical Medicine and Rehabilitation (Physiatry) and fellowship-trained in Interventional Orthopedics and Spine. Dr. Hyzy is also clinical faculty at the University of Colorado School of Medicine in the Department of Physical Medicine and Rehabilitation; In addition, Dr. Hyzy is an Adjunct Clinical Assistant Professor at The Rocky Vista University College of Osteopathic Medicine. Dr. Hyzy also maintains an active hospital-based practice at Swedish Medical Center and Sky Ridge Medical Center. He is also recognized and qualified as an expert physician witness for medical-legal cases and Life Care Planning. He is published in the use of autologous solutions including…

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Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

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Mairin Jerome, MD

Mairin Jerome, MD

Dr. Mairin Jerome is a physiatrist with subspecialty fellowship training in Interventional Orthopedics and Regenerative Medicine. This subspecialty serves to fill the gap for patients who are interested in therapeutic options that lie between conservative treatment and surgery. Dr. Jerome uses regenerative medicine techniques, including prolotherapy and orthobiologics, via X-ray or ultrasound guidance to precisely deliver injections to areas of musculoskeletal injury or degeneration. Orthobiologics refers to tissue harvested typically from a person’s own body, such as platelets (platelet-rich plasma, PRP) or bone marrow, for use in treating painful musculoskeletal conditions. The goal is to stimulate the body’s healing mechanisms to improve pain, function, and decrease inflammation.

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Said J, Van Nest D, Foltz C, Ilyas AM. Ulnar Nerve In Situ Decompression versus Transposition for Idiopathic Cubital Tunnel Syndrome: An Updated Meta-Analysis. J Hand Microsurg. 2019 Apr;11(1):18-27. doi: 10.1055/s-0038-1670928. Epub 2018 Sep 27. PMID: 30911208; PMCID: PMC6431285.

Osei DA, Groves AP, Bommarito K, Ray WZ. Cubital Tunnel Syndrome: Incidence and Demographics in a National Administrative Database. Neurosurgery. 2017 Mar 1;80(3):417-420. doi: 10.1093/neuros/nyw061. PMID: 28362959.

Ayache A, Unglaub F, Tsolakidis S, Schmidhammer R, Löw S, Langer MF, Spies CK. Revisionseingriffe beim Karpal- und Kubitaltunnelsyndrom [Revision surgery for carpal and cubital tunnel syndrome]. Orthopade. 2020 Sep;49(9):751-761. German. doi: 10.1007/s00132-020-03969-7. PMID: 32857166.

Kholinne E, Alsharidah MM, Almutair O, Aljasser S, Alhothali W, Kwak JM, Sun Y, Lee HJ, Koh KH, Jeon IH. Revision surgery for refractory cubital tunnel syndrome: A systematic review. Orthop Traumatol Surg Res. 2019 Sep;105(5):867-876. doi: 10.1016/j.otsr.2019.03.020. Epub 2019 Jul 19. PMID: 31331798.