Decompression with Brachioradialis Tenotomy Improves Pain and Quality of Life in Patients with Radial Sensory Nerve Compression

Background: Decompression of the superficial sensory branch of the radial nerve (SBRN) with complete brachioradialis tenotomy may treat pain in both simple and complex cases of SBRN compression neuropathy. Methods: A retrospective chart review was performed of consecutive patients undergoing this procedure between 2008 and 2020 including postoperative outcomes within 90 days. Data were collected and analyzed, including patient and injury demographics, pain descriptors, and patient-reported pain questionnaire, including reported pain severity and impact on quality of life using visual analogue scale (VAS) instruments. Within-group presurgical and postsurgical analyses and between-group statistical analyses were performed. Results: Thirty-three of 58 patients met inclusion criteria. Median time from symptom onset to surgery was 300 days, and median postoperative follow-up time was 37 days. Twenty-five percent of patients (n = 8) underwent isolated SBRN decompression. The remainder had concomitant decompression of another radial [n = 16 (48%) or peripheral [n = 12 (36%)] entrapment point. Ten of 33 patients (30%) had resolution of pain at final follow-up (P = 0.004). Median change in worst pain over the previous week was -4 (P < 0.001), and average pain over the last month was -2.75 (P < 0.001) on the VAS. The impact of pain on quality of life showed a median change of -3 (P < 0.001) on the VAS. Conclusion: Decompression of the sensory branch of the radial nerve including a complete brachioradialis tenotomy improves pain and quality-of-life VAS scores in patients with both simple compression neuropathy syndrome and complex nerve compression syndrome. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.