For patients with lower-extremity painful diabetic peripheral neuropathy (DPN), nerve decompression is associated with reduced pain, although these effects may be partly due to a placebo effect, according to a study published online Feb. 8 in the Annals of Surgery.
Shai M. Rozen, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues examined the effect of nerve decompression on pain in patients with lower-extremity painful DPN. Patients aged 18 to 80 years with lower-extremity painful DPN were randomly assigned to receive nerve decompression or observation in a 2:1 ratio. Decompression group patients were further randomly assigned to receive nerve decompression in either the right or left leg and sham surgery in the opposite leg (22 and 18 patients in the right- and left-decompression groups, respectively).
The researchers found that compared with the 37 controls, the right- and left-decompression groups reported significantly lower pain (mean difference for both, −4.46) at 12 months. Equal improvement was seen in decompressed and sham legs. Compared with 14 controls, at 56 months, pain was significantly lower in the right-decompression group (20 patients) and left-decompression group (16 patients; mean differences, −7.65 and −7.26, respectively). In the decompressed versus sham legs, the mean pain score was significantly lower (mean difference, 1.57).
“The current data does not provide definitive evidence for benefit of surgical decompression in painful diabetic peripheral neuropathy,” the authors write.
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