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.
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References
Aszmann O, Tassler PL, Dellon AL (2004) Changing the natural history of diabetic neuropathy: incidence of ulcer/amputation in the contralateral limb of patients with a unilateral nerve decompression procedure. Ann Plast Surg 53(6):517–522
Bril V, Pcrkill B (2002) Validation of the Toronto Clinical Scoring System for diabetic polyneumpathy. Diabetes Care 25:2048–2052
Chauplannaz G, Vial C (2004) Electrodiagnositic assessment of neuromuscular junction disorders. Rev Med Liege 59:184–189
Dellon AL (1992) Treatment of symptomatic diabetic neuropathy by surgical decompression of multiple peripheral nerves. Plast Reconstr Surg 89(4):689–697
Dellon AL (2002) Preventing foot ulceration and amputation by decompressing peripheral nerves in patients with diabetic neuropathy. Ostomy/Wound Manag 48(9):36–45
Dellon AL, Aszmann OA, Tassler P (2003) Outcome of surgical decompression of nerves in diabetic on incidence of ulceration and amputation. J Reconstr Microsurg 19:350–355
Dellon AL (2007) Neurosurgical prevention of ulceration and amputation by decompression of lower extremity peripheral nerves in diabetic neuropathy: update 2006. Acta Neurochir Suppl 100:149–151
Kincaid JC, Price KL, Jimenez MC, Skljarevski V (2007) Correlation of vibratory quantitative sensory testing and never conduction studies in patients with diabetes. Muscle Nerve 36(6):821–827
Onde ME, Ozge A, Senol MG, Togrol E, Ozdag F, Saracoglu M, Misirli H (2008) The sensitivity of clinical diagnostic methods in the diagnosis of diabetic neuropathy. J Int Med Res 36(1):63–70
Orstavik K, Norheim L, Jorum E (2006) Pain and small-fiber neuropathy in patients with hypothyroidism. Neurology 67:786–791
Peter STC, Didier PC (2004) Technology lecture review: quantitative sensory testing. Muscle Nerve 29:734–747
Rader AJ (2005) Surgical decompression in lower-extremity diabetic peripheral neuropathy. J Am Podiatr Med Assoc 95(5):446–450
Reiber GE (1996) The epidemiology of diabetic foot problems. Diabet Med 13(Suppl 1):S6–S11
Rutkove SB, Veves A, Mitsa T, Nie R, Fogerson PM, Garmirian LP, Nardin RA (2009) Impaired distal thermoregulation in diabetes and diabetic polyneuropathy. Diabetes Care 32(4):671–676
Sangiorgio L, Iemmolo R, Le Moli R, Grasso G, Lunetta M (1997) Diabetic neuropathy: prevalence, concordance between clinical and electrophysiological testing and impact of risk factors. Panminerva Med 39(1):1–5
Siemionow M, Zielinski M, Sari A (2006) Comparison of clinical evaluation and neurosensory testing in the early diagnosis of superimposed entrapment neuropathy in diabetic patients. Ann Plast Surg 57(1):41–49
Sirmreieh M, Taylor BV, Dyck PJ (2005) Diabetic neuropathies classification, clinical features and pathophysiological basis. Neurologist 11:63–79
Acknowledgments
The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper. This study was supported by a grant from the National Science Foundation of China (NSFC, No. 30800316). The authors are grateful to the Science and Technology Commission for the funding of this study.
Clinical trial registration number was No. 30800316.
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All the authors have no conflicts.
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Zhong, W., Zhang, W., Yang, M. et al. Impact of diabetes mellitus duration on effect of lower extremity nerve decompression in 1,526 diabetic peripheral neuropathy patients. Acta Neurochir 156, 1329–1333 (2014). https://doi.org/10.1007/s00701-014-2087-8
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DOI: https://doi.org/10.1007/s00701-014-2087-8