Abstract
Background Over the last decade, surgical decompression procedures have been commonly used in
the treatment of diabetic peripheral neuropathy. However, the effectiveness of them
remains to be proved.
Methods A comprehensive literature search of databases including PubMed-Medline, Ovid-EMBASE,
and Cochrane Library was performed to collect the related literatures. The Medical
Subject Headings used were “diabetic neuropathy,” “surgical decompression,” and “outcomes.”
The methodological index for nonrandomized studies was adopted for assessing the studies
included in this review. Analyses were performed with Review Manager (Version 5.3,
Copenhagen: The Nordic Cochrane Centre, the Cochrane Collaboration, 2014).
Results A total of 12 literatures (including 8 prospective and 4 retrospective) encompassing
1,825 patients with DPN were included in the final analysis. Only one literature was
identified as a randomized controlled trial. The remaining 11 literatures were observational
studies; 7 of them were classified as upper-extremity nerve decompression group and
4 of them were classified as lower-extremity nerve decompression group. Meta-analysis
shows that Boston questionnaire symptom severity and functional status of upper extremities,
and distal motor latency and sensory conduction velocity of median nerve of DPN patients
are significantly improved after carpal tunnel release. Besides, visual analog scale
and two-point discrimination are considered clinically and statistically significant
in lower extremities after operation.
Conclusions The findings from our review have shown the efficacy of surgical decompression procedures
in relieving the neurologic symptoms and restoring the sensory deficits in DPN patients.
As there are few high-quality randomized controlled trials or well-designed prospective
studies, more data are needed to elucidate the role of surgical procedures for DPN
treatment in the future.
Keywords
diabetes - peripheral neuropathy - nerve decompression
