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J Reconstr Microsurg 2018; 34(06): 446-454
DOI: 10.1055/s-0038-1636938
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Mechanical Allodynia Predicts Better Outcome of Surgical Decompression for Painful Diabetic Peripheral Neuropathy

Chenlong Liao
1   Department of Neurosurgery, XinHua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, Republic of China
,
D. Scott Nickerson
2   Wound Care Center of NE Wyoming, Sheridan, Wyoming
,
Massimiliano Visocchi
3   Department of Neurosurgery, Catholic University School of Medicine, Rome, Italy
,
Min Yang
1   Department of Neurosurgery, XinHua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, Republic of China
,
Pengfei Liu
1   Department of Neurosurgery, XinHua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, Republic of China
,
Wenxiang Zhong
1   Department of Neurosurgery, XinHua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, Republic of China
,
Han Zhou
1   Department of Neurosurgery, XinHua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, Republic of China
,
Wenchuan Zhang
1   Department of Neurosurgery, XinHua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, Republic of China
› Author Affiliations Funding This work was supported by the National Science Foundation of China (no. 81371373) and Medical-engineer cross-fund of Shanghai JiaoTong University (grant no. YG2014QN18).
Further Information

Publication History

04 November 2017

18 January 2018

Publication Date:
22 March 2018 (online)

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Abstract

Background To determine the role of mechanical allodynia (MA) in predicting good surgical outcome for painful diabetic peripheral neuropathy (DPN).

Materials and Methods Data of 192 patients with painful DPN were collected in this study, with 148 surgical patients and 44 patients in the control group. Both groups were further divided into subgroups based on the presence of MA on admission. Clinical evaluations including the visual analog scale (VAS), the Hospital Anxiety and Depression Scale (HADS), nerve conduction velocity (NCV), and high-resolution ultrasonography (cross-sectional area, CSA) were performed preoperatively and postoperatively.

Results The levels of VAS and HADS and the results of NCV and CSA were improved in the surgical group (p < 0.05). In the surgical subgroups, pain reduction, psychiatric amelioration, improvement in NCVs, and the restoration of the CSA were observed in patients with signs of MA (p < 0.05), whereas only pain reduction, psychiatric amelioration, and restoration of the CSA were noted in patients without signs of MA (p > 0.05). Furthermore, better pain reduction was achieved in patients with MA when compared with those without MA (p < 0.05).

Conclusions MA is proved to be a reliable predictor of good surgical outcome for painful DPN.

Keywords

diabetic peripheral neuropathy - mechanical allodynia - nerve decompression
 

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