My Account Login | Signup ( [query_status] => Array ( [query_status_code] => OK [query_status_description] => Query successfully performed. ) [ip_address] => [geolocation_data] => Array ( [continent_code] => NA [continent_name] => North America [country_code_iso3166alpha2] => US [country_code_iso3166alpha3] => USA [country_code_iso3166numeric] => 840 [country_code_fips10-4] => US [country_name] => United States [region_code] => VA [region_name] => Virginia ) )
Editorial Board
Submit article
Join as Reviewer/Editor
List of Reviewer
Indexing Information
Most popular articles
Free Articles
Purchase Single Articles
Current Issue
Recommend this journal to your library
Accepted Articles
Search Articles
Email Alerts
Contact Us
International Journal of Neurology and Neurosurgery

Volume  4, Issue 1, January - June 2012, Pages 21-25


Review Article

Surgical Management of Painful Diabetic Peripheral Neuropathy: A Focused Review
Senthil P.Kumar,Prabha Adhikari,P.S.Jeganathan,Z.K.Misri
*Associate Professor, Dept of Physiotherapy, **Professor, Dept of Medicine, ***Professor, Dept of Physiology, ****Associate Professor, Dept of Neurology, Kasturba Medical College (Manipal University), Mangalore, India.
Choose an option to locate / access this Article:
Check if you have access through your login credentials.             |


Peripheral diabeticneuropathy (PDN) is one of the major complications arising in patients with diabetes.A triad of metabolic abnormalities is known that render the peripheral nerve in diabetes mellitus susceptible to chronic compression: conversion of glucose to sorbitol increases the intraneural water content, slowing of axoplasmic transport of proteins hinders structural repair, glycosylation of endoneurial collagen reduces perineurial gliding. Due to connective tissue fibrosis, impaired microcirculation, and impaired endoneurial oxygenation, diabetic peripheral nerves are more at risk for entrapment neuropathies both focally and diffusely.Surgical release and decompression was shown to be effective in many entrapment neuropathies but not in diabetes, hence there is a dearth need to evaluate the current evidence on surgical decompression’s effectiveness in diabetic peripheral neuropathy (DPN).The objective of this review is to provide and evidence-informed update on the effects, efficacy and effectiveness of surgical treatments in patients with painful diabetic peripheral neuropathy (PDPN). MEDLINE was searched for articles and 23 studies were obtained and a descriptive review found that surgical decompression of superimposed nerve compressions in the patient with symptomatic neuropathy reliably relieves pain, restores sensation, and thereby prevents ulceration and amputation. Surgical decompression is thus an established critical, practical and a successful treatment option for patients with PDPN.

Keywords: Diabetic peripheral neuropathy; Decompressive surgery; Operative management.  

Corresponding Author : Senthil P.Kumar