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Background <p>Cubital tunnel syndrome (CuTS) caused by elbow ganglion cysts, characterized by abrupt onset or sudden exacerbation of ulnar nerve symptoms, is a rare condition with few reported cases. The current study aims to retrospectively assess the surgical treatment outcomes of patients with CuTS with acute symptom exacerbation caused by ganglion cysts from elbow joint.</p> Methods <p>From January 2023 to June 2024, patients diagnosed with CuTS with acute symptom exacerbation who were admitted to our hospital and followed up. Routine X-ray was performed to evaluate the degeneration of the elbow joint. Ultrasound test was used to evaluate the morphology of the ulnar nerve and ganglion cysts, especially in the elbow joint. Sensory deficit assessment of little finger according to British Medical Research Council Sensory Function Assessment Standards (BMRCS) and motor function assessment according to Medical Research Council (MRC) Scale for interosseous muscles strength were introduced. Surgical interventions including anterior subcutaneous transposition of the ulnar nerve and ganglion cyst resection were performed. Visual analogue scale (VAS) score was used to evaluate the pain of the patients. All the above parameters were collected and analyzed at the time points of pre-operation and final follow-up.</p> Results <p>A total of 32 patients was followed up with a mean age of 54.94 years, including 6 females and 26 males with 10 left and 22 right limbs affected. The period of follow-up ranges from 6 to 22 months (11.6 ± 5.4 months) post-operation. The X-ray indicated that 30 patients had osteoarthritis of the elbow joint. The symptom duration ranges from 0.5 to 24 months (6.0 ± 5.5 months). There were 4 cases of intraneural cysts and 28 cases of extraneural cysts according to ultrasound findings. In terms of sensory recovery, 18 cases (56.25%) achieved ≥ S3 + recovery, and of muscle strength recovery, 19 cases (59.375%) achieved ≥ M4 recovery post-operation. The parameters of sensory and muscle strength recovery above showed significant improvement (<i>P</i> = 0.0000038, and 0.0001318). The patients got significant pain relief after surgery according to the VAS scale with 16 cases (50%) experiencing complete disappearance of pain (<i>P</i> = 0.0000017).</p> Conclusions <p>For CuTS caused by elbow ganglion cysts presenting with abrupt onset or sudden exacerbation of symptoms, accurate diagnosis and surgical treatment was associated with improvement in pain and neurological parameters, though complete functional recovery is not guaranteed. In addition, distinguishing between intraneural and extraneural cysts may be informative for postoperative surveillance and individualized follow-up planning.</p>

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Surgical outcomes of cubital tunnel syndrome with acute symptom exacerbation caused by elbow ganglion cysts: a retrospective case series of 32 patients

  • 期刊论文

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  • 发表日期：

    2026年7月4日

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  • Xu-Cheng Guo,
  • Hang Zhang,
  • Jing Wang,
  • Ji-Kun Hao,
  • Jie Ren,
  • Xiao-Chen Shi,
  • Rui Cong,
  • Hang Xian

摘要

Background

Cubital tunnel syndrome (CuTS) caused by elbow ganglion cysts, characterized by abrupt onset or sudden exacerbation of ulnar nerve symptoms, is a rare condition with few reported cases. The current study aims to retrospectively assess the surgical treatment outcomes of patients with CuTS with acute symptom exacerbation caused by ganglion cysts from elbow joint.

Methods

From January 2023 to June 2024, patients diagnosed with CuTS with acute symptom exacerbation who were admitted to our hospital and followed up. Routine X-ray was performed to evaluate the degeneration of the elbow joint. Ultrasound test was used to evaluate the morphology of the ulnar nerve and ganglion cysts, especially in the elbow joint. Sensory deficit assessment of little finger according to British Medical Research Council Sensory Function Assessment Standards (BMRCS) and motor function assessment according to Medical Research Council (MRC) Scale for interosseous muscles strength were introduced. Surgical interventions including anterior subcutaneous transposition of the ulnar nerve and ganglion cyst resection were performed. Visual analogue scale (VAS) score was used to evaluate the pain of the patients. All the above parameters were collected and analyzed at the time points of pre-operation and final follow-up.

Results

A total of 32 patients was followed up with a mean age of 54.94 years, including 6 females and 26 males with 10 left and 22 right limbs affected. The period of follow-up ranges from 6 to 22 months (11.6 ± 5.4 months) post-operation. The X-ray indicated that 30 patients had osteoarthritis of the elbow joint. The symptom duration ranges from 0.5 to 24 months (6.0 ± 5.5 months). There were 4 cases of intraneural cysts and 28 cases of extraneural cysts according to ultrasound findings. In terms of sensory recovery, 18 cases (56.25%) achieved ≥ S3 + recovery, and of muscle strength recovery, 19 cases (59.375%) achieved ≥ M4 recovery post-operation. The parameters of sensory and muscle strength recovery above showed significant improvement (P = 0.0000038, and 0.0001318). The patients got significant pain relief after surgery according to the VAS scale with 16 cases (50%) experiencing complete disappearance of pain (P = 0.0000017).

Conclusions

For CuTS caused by elbow ganglion cysts presenting with abrupt onset or sudden exacerbation of symptoms, accurate diagnosis and surgical treatment was associated with improvement in pain and neurological parameters, though complete functional recovery is not guaranteed. In addition, distinguishing between intraneural and extraneural cysts may be informative for postoperative surveillance and individualized follow-up planning.