Short-term efficacy of dual-scope surgery for painful diabetic peripheral neuropathy

LU Jiaye; YANG Yayi; HAN Runze; WANG Zilan; CHEN Zhouqing; WANG Zhong

doi:10.3969/j.issn.1671-2897.2025.06.011

Abstract：Objective To investigate the short-term efficacy of dual-scope(microscope combined with neuroendoscope)neurolysis in the treatment of diabetic painful peripheral neuropathy.Methods The study retrospectively included 21 patients with painful diabetic peripheral neuropathy who underwent surgical treatment in the Department of Neurosurgery at the First Affiliated Hospital of Soochow University from January 2023 to December 2024.All patients underwent neurolysis using the dual-scope technique.General data,including age and diabetes history,as well as preoperative electromyography and musculoskeletal ultrasound findings,were collected.Perioperative assessments included the Visual Analog Scale(VAS),Toronto Clinical Scoring System(TCSS),surgical incision length,and postoperative wound healing.Results All patients successfully completed the surgery,with a total of 86 nerves released.Incision lengths ranged from 3-4 cm for ulnar nerve release at the Guyon's canal and tibial nerve release,and 1-2 cm for other nerves.Preoperative VAS and TCSS scores were 6.57±0.87 and 13.76±1.73 respectively.At 1-month follow-up,scores improved significantly to 1.76±1.09(VAS)and 9.10±1.14(TCSS)(both P<0.01).No complications,such as poor wound healing or infection,occurred during the perioperative or follow-up periods.Conclusions The dual-scope neurolysis technique innovatively integrates microscope and neuroendoscope technologies,providing a stereoscopic and clear surgical field while minimizing incision size.This approach reduces the risk of poor wound healing in diabetic patients and offers a novel surgical strategy for diabetic peripheral neuropathy.