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Tibial nerve decompression failed to improve painful diabetic polyneuropathy
Surgical decompression of the tibial nerve did not yield significant improvements in patients with painful diabetic polyneuropathy, according to data published in Diabetes Care.
Previous studies have suggested that the procedure has the potential to relieve pain, sensitivity, improve balance, mitigate long-term risk for ulcers and amputations, and improve quality of life.
“Polyneuropathy is a common complication in diabetes. Because of diabetes mellitus and changes in glucose levels, nerves will swell due to osmosis and ligamental structures will be stiffer and thicker,” researchers wrote. “In this study we aimed to demonstrate the changes in these structures and the influence of decompression of tarsal tunnel on the tibial nerve at the ankle using ultrasound.”
The researchers compared the mean cross-sectional area and any changes in shape of the tibial nerve before and after decompression of the tarsal tunnel in a randomized controlled trial of 42 patients with reportedly painful diabetic polyneuropathy compared with 38 healthy controls.
The mean cross-sectional area was substantially larger in patients with painful diabetic polyneuropathy (8.4 ± 3.9 mm2) compared with controls (6.4 ± 1.3 mm2; P=.007), according to data.
Moreover, the thickness/width ratio in patients with painful diabetic polyneuropathy was 0.64 and 0.59 in controls (P=.03). However, patients with diabetic polyneuropathy displayed a significantly thicker retinaculum (1.1 mm) compared with controls (0.84 mm; P<.005), researchers wrote.
They said there should be a larger randomized control trial to determine the conduction velocity at the ankle site before and after decompressive surgery.
Disclosure: The researchers report no relevant financial disclosures.