Cui Dongqiang, Yang Ming, Qiao Yang, Gong Zhenxing, Hu Zeqing, Ma Zhuang, Wu Yang, Huo Guitong
Department of Neurosurgery, Xingtai Ninth Hospital, Xingtai, China.
Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Front Neurol. 2025 Aug 21;16:1619851. doi: 10.3389/fneur.2025.1619851. eCollection 2025.
The aim of this study was to evaluate the clinical outcomes of spinal cord stimulation (SCS) in patients with painful diabetic peripheral neuropathy (PDPN).
Ninety-two patients underwent permanent SCS implantation and completed a 6-month post-operative follow-up. The primary endpoint was patient amputation rate, and secondary endpoints included Quality of Life (QOL LC V2.0) scale, pain visual analogue scale (VAS), limb nerve conduction velocity, latency and amplitude, and vibration perception threshold (VPT).
In patients with diabetic peripheral neuropathy, QOL LC V2.0 and VAS scores were significantly improved at 6 months postoperatively compared to preoperatively (24.74%, < 0.05; 71.87%, < 0.05). Compared with the median and ulnar nerves of the upper extremity peripheral nerves, the conduction velocities of the common peroneal, sural, superficial peroneal and tibial nerves of the lower extremity peripheral nerves were increased ( < 0.05), the latency was significantly shortened ( < 0.05) and the amplitude was significantly increased ( < 0.05) at 6 months after surgery. Compared to the dorsum of the hand, VPTs were significantly lower in the first toe and dorsum of the foot at 6 months postoperatively compared to preoperatively ( < 0.05). The overall amputation rate was 8.69%, with 3.26% for major amputation (above the ankle) and 5.43% for minor amputation (below the ankle).
SCS can effectively relieve lower limb pain in patients with diabetic peripheral neuropathy, repair lower limb peripheral nerves, improve patients' quality of life, and reduce amputation rate.
本研究旨在评估脊髓刺激（SCS）治疗疼痛性糖尿病周围神经病变（PDPN）患者的临床疗效。
92例患者接受了永久性SCS植入，并完成了术后6个月的随访。主要终点是患者截肢率，次要终点包括生活质量（QOL LC V2.0）量表、疼痛视觉模拟量表（VAS）、肢体神经传导速度、潜伏期和波幅，以及振动觉阈值（VPT）。
糖尿病周围神经病变患者术后6个月时，QOL LC V2.0和VAS评分较术前显著改善（分别为24.74%，P<0.05；71.87%，P<0.05）。与上肢周围神经的正中神经和尺神经相比，下肢周围神经的腓总神经、腓肠神经、腓浅神经和胫神经的传导速度在术后6个月时增加（P<0.05），潜伏期显著缩短（P<0.05），波幅显著增加（P<0.05）。与手背相比，术后6个月时第一趾和足背的VPT较术前显著降低（P<0.05）。总体截肢率为8.69%，其中大截肢（踝关节以上）率为3.26%，小截肢（踝关节以下）率为5.43%。
SCS可有效缓解糖尿病周围神经病变患者的下肢疼痛，修复下肢周围神经，改善患者生活质量，并降低截肢率。
