Preventing foot ulceration and amputation by decompressing peripheral nerves in patients with diabetic neuropathy.

Diabetic neuropathy occurs in a stocking and glove distribution, consistent with a systemic metabolic disease. As a result, it is commonly believed that no surgical options are available for this debilitating condition. The classic medical approach to the treatment of diabetic neuropathy consists of attempts to achieve a euglycemic state, obtain regular podiatric care of the feet, inspect the feet for the presence of deformities or ulcers, and help achieve pain control through the use of medication. Unfortunately, all too often this approach is not successful in relieving the patient's pain, and the loss of sensation provides the basis for deformity, ulceration, infection, and amputation. However, scientific and clinical research data support the statement that "today it is possible to restore sensation and relieve pain in 80% of patients with symptoms of diabetic neuropathy by decompression of multiple peripheral nerves." Furthermore, long-term follow-up has shown that no one who has had sensation restored with this procedure has developed an ulcer. These findings change the natural sequelae of diabetic neuropathy.