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Surgical Decompression for Diabetic Neuropathy in the Foot

Not Applicable
Completed
Conditions
Diabetic Polyneuropathy
Interventions
Procedure: Surgery
Registration Number
NCT01006915
Lead Sponsor
Timothy J. Best Medicine Professional Corporation
Brief Summary

The purpose of the study is to determine whether or not surgical decompression of the common peroneal, tibial, and deep peroneal nerves in the legs of persons with diabetic peripheral neuropathy is effective treatment.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
21
Inclusion Criteria
  • Age >18 years
  • Presence of Type 1 or 2 diabetes mellitus (fasting plasma glucose > 7 mmol/L or casual plasma glucose > 11.1 mmol/L and symptoms of diabetes or a 2hr plasma glucose in a 75g oral glucose tolerance test > 11.1 mmol/L)
  • Symptoms of paresthesias (including burning pain) or numbness present symmetrically in both feet, determined to be on a peripheral nerve basis
  • Total Neuropathy score of ≥ 2 based on symptoms, signs, and nerve conduction study abnormality
  • Average pain on Likert scale (range 0 - 10) ≥5
  • Good diabetic control with Hgb A1C < 8
  • Presence of Tinel's sign at the Tarsal Tunnel
  • Possession of valid Ontario Hospital Insurance Plan (OHIP) coverage
Exclusion Criteria
  • Other types of diabetes mellitus (gestational, drug-induced, etc.)
  • Other cause of neuropathy than diabetes such as vasculitis, amyloidosis, toxic neuropathy, HIV, renal failure, alcohol abuse, etc. Pure entrapment neuropathy without evidence of DSP
  • Symptomatic lumbosacral spine disease
  • Symptomatic lower extremity vascular disease
  • Previous foot ulceration or amputation. Other contraindications to surgery such as significant ankle edema, venous stasis, morbid obesity, or previous surgery/injury which would be incompatible with appropriate wound healing
  • History of Peripheral Arterial Disease
  • HbA1c > 8.0 - Adults lacking capacity to consent, pregnant women, prisoners, non-English speakers who require an interpreter, and those unwilling or unable to participate in the full study follow-up

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Surgical decompressionSurgerySurgical decompression of the common peroneal, tibial, and deep peroneal nerves
Primary Outcome Measures
NameTimeMethod
To determine if lower extremity nerve decompression in patients suffering from symptomatic diabetic peripheral neuropathy significantly alleviates pain.0,3,6, and 12 months
Secondary Outcome Measures
NameTimeMethod
Nerve Conduction Velocity0 and 12 months
Neuropathic Symptoms as measured by the Total Neuropathy Score (TNS)0,3,6, and 12 months
Quality of Life0,3,6, and 12 months
Signs of peripheral neuropathy - two-point discriminations and pressure thresholds, vibration sensibility0 and 12 months

Trial Locations

Locations (1)

Sault Area Hospital

🇨🇦

Sault Ste. Marie, Ontario, Canada

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