Efficacy analysis of quadruple nerve decompression in the treatment of painful diabetic peripheral neuropathy of lower extremity
Objective To investigate the effect of quadruple nerve decompression in the treatment of painful diabetic peripheral neuropathy of lower extremity.Methods The clinical data of 24 patients(40 sides)with painful diabetic peripheral neuropathy of lower extremities were retrospectively analyzed in the Department of Neurosurgery at China-Japan Friendship Hospital from January 2020 to December 2020.Those patients underwent quadrilateral decompression surgery on their peripheral nerves,including the common peroneal nerve of the peroneal canal,deep peroneal nerve of the dorsal foot,superficial peroneal nerve of the anterior lower leg 1/3,and medial ankle posterior tibial nerve and its branches.All patients were followed up every three months after discharge for evaluation using Visual Analogue Scale(VAS),two-point discernability(TPD),sensory nerve conduction velocity(SCV),and Toronto Clinical Neuropathy Score(TCSS).Preoperative and postoperative comparisons were performed to evaluate the surgical efficacy.Results All patients successfully underwent the operations.No postoperative complications occurred.The 24 patients were followed up for 28.5±8.7 months(14-44 months).Up to the last follow-up,compared with those before surgery,postoperative VAS score of 40 sides(1.85±1.23 points vs.6.53±1.13 points),TPD measurement results(7.48±2.35 mm vs.13.00±3.16 mm),SCV of common peroneal nerve(CPN)(42.13±2.97 m/s vs.35.75±3.28 m/s)and SCV of posterior tibial nerve(PTN)(42.07±2.75 m/s vs.35.02±3.03 m/s)were improved,and the differences were statistically significant(all P＜0.001).The results of TCSS showed that all 24 patients had severe diabetic peripheral neuropathy before surgery,2 had severe,15 had moderate,and 7 had mild diabetic peripheral neuropathy after surgery.Postoperative TCSS was significantly improved compared with preoperative TCSS(9.42±1.53 points vs.13.88±1.08 points,P＜0.001).Conclusions Quadruple decompression of peripheral nerve can improve the pain symptoms and nerve function of patients with painful diabetic peripheral neuropathy of lower extremity.It is an effective method for the treatment of painful diabetic peripheral neuropathy of lower extremity.
Peripheral nervous system diseasesDiabetic neuropathyLower extremityDecompression,surgeryTreatment outcomeQuadruple nerve decompression
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