Impact of diabetes mellitus duration on effect of lower extremity nerve decompression in 1,526 diabetic peripheral neuropathy patients

Acta Neurochir (Wien). 2014 Jul;156(7):1329-33. doi: 10.1007/s00701-014-2087-8. Epub 2014 Apr 24.

Abstract

Background: Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes mellitus (DM). The aim of this study was to analyze DM duration in the prognosis of diabetic peripheral neuropathy of the lower extremity.

Methods: A total of 1,526 DPN patients who were treated with DELLON surgical nerve decompression were divided into a short DM duration group and long DM duration group using a length of 5 years as the standard duration. Before and 1.5 years after surgery, high-resolution ultrasound, quantitative sensory testing (QST), and nerve conduction velocity (NCV) were performed and compared to the normal control.

Results: Postoperative NCV of all the patients in either treatment group significantly increased (p < 0.05) and postoperative CSA significantly decreased (p < 0.05) compared with that before surgery. The CPT significantly increased compared with the preoperative value (p < 0.05). The postoperative WPT was significantly lower than the preoperative value (p < 0.01), and the postoperative VPT was significantly lower than the preoperative value (p < 0.05). Overall, the postoperative NCV, CSA, CPT, WPT, and VPT values from the short DM duration group were significantly different from that of the long DM duration group (p < 0.05).

Conclusions: The duration of DM is critical to the prognosis of DPN of the lower extremity, and the data from this study suggest that an early diagnosis and subsequent surgery for DPN have important clinical value.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Decompression, Surgical / methods*
  • Diabetic Neuropathies / diagnostic imaging
  • Diabetic Neuropathies / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neural Conduction
  • Neurologic Examination
  • Prognosis
  • Sensation
  • Treatment Outcome
  • Ultrasonography