Microsurgical decompression of peripheral nerves for treatment of dialysis-related peripheral neuropathy of lower limbs
Objective To investigate the efficacy of microsurgical decompression of peripheral nerves in the treatment of lower limb dialysis-associated peripheral neuropathy(DRPN)in the lower limbs.Methods The clinical data of 21 patients with DRPN in their lower limbs,who were admitted to the Department of Neurosurgery of China-Japan Friendship Hospital from January 2018 to December 2022,were retrospectively analyzed.Microsurgical decompression was performed on the common peroneal nerve(CPN),posterior tibial nerve(PTN)and its three branches in all 21 patients with a total of 42 affected limbs.All patients were followed up after discharge,which included recording their symptom relief and review of EMG(electromyography)to assess the efficacy.Results All 21 cases underwent successful operations.The mean follow-up time for these patients was 22.5±9.9 months(range:12 to 48 months).Up to the last follow-up,the results of EMG review showed that compared with preoperative values,there was a significant increase of CPN in the sensory nerve conduction velocity(42.2±3.7 m/s vs.33.2±4.1 m/s)and action potential amplitude(9.2±1.5 mV vs.5.8±1.1 mV),as well as the motor nerve conduction velocity(44.2±3.1 m/s vs.37.0±3.9 m/s)and action potential amplitude(9.1±1.6 mV vs.6.4±1.3 mV)(all P＜0.05).PTN also exhibited an increase in the sensory nerve conduction velocity from(43.3±2.8 m/s vs.34.1±4.5 m/s)and action potential amplitude(9.1±1.6 mV vs.6.3±1.2mV),as well as the motor nerve conduction velocity(43.0±3.2 m/s vs.36.7±4.8m/s)and action potential amplitude(8.7±1.7 mV vs.6.8±1.3 mV)(all P＜0.05).Up to the last follow-up,numbness on 36 sides(85.7％)of the affected limb was relieved in 21 patients,pain symptoms on 42 sides(100.0％)were relieved,and motor function of the affected limb on 38 sides(90.5％)was relieved.Conclusions Microsurgical decompression of the peripheral nerve can effectively improve the nerve conduction velocity and action potential amplitude of lower limb NRPN pationts,and alleviate their limb symptoms.So it is an effective method for the treatment of DRPN in the lower limbs.
Peripheral nervous system diseasesDialysisLower limbsPeripheral nerveMicro-decompression
NETL
NSTL
万方数据
