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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Association Between Ultrasonographic Evidence of Nerve Entrapment and Pain Outcomes After Nerve Decompression in Painful Diabetic Peripheral Neuropathy

  • Ze Zhang1
  • Qi Wang2
  • Zhenxuan Gao2
  • Wenqiang Yang2
  • Shuguang Cai3
  • Quanyu Jin3
  • Jiaxin Liu4
  • Chenchen Kong3
  • Abudurezhake Aerman1
  • Lei Kou1
  • Li Zhang1,2
4 affiliations
  1. 1Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China
  2. 2Department of Neurosurgery, China-Japan Friendship Hospital, Beijing 100029, China
  3. 3Department of Neurosurgery, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100029, China
  4. 4Department of Neurosurgery, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing 100029, China
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Abstract

Objective: To evaluate whether preoperative ultrasonographic evidence of nerve entrapment is associated with pain relief after lower-limb peripheral nerve decompression in patients with painful diabetic peripheral neuropathy (PDPN). Methods: This single-center retrospective cohort study included 110 consecutive patients with PDPN who underwent bilateral lower-limb peripheral nerve decompression between February 2023 and June 2024. After three patients were lost to follow-up, 107 were analyzed. Preoperative ultrasonography assessed the bilateral common peroneal and tibial nerves. Patients were classified as ultrasound-positive if at least one examined nerve met the specified focal entrapment criteria and as ultrasound-negative otherwise. Numeric rating scale (NRS) scores were recorded preoperatively and at 7 days, 6 months, and 12 months after surgery. A ≥50% reduction in NRS score at 12 months was defined as pain response. Analysis of covariance and multivariable logistic regression were performed. Results: Ultrasonographic evidence of focal entrapment in at least one examined common peroneal or tibial nerve was identified in 42 patients (39.3%). Mean NRS scores decreased from 7.9 preoperatively to 2.7, 2.5, and 2.7 at 7 days, 6 months, and 12 months, respectively (all Holm-adjusted p < 0.001). After adjustment for baseline NRS score, the ultrasound-positive group had lower NRS scores at 7 days and 12 months than the ultrasound-negative group; the between-group difference was not statistically significant at 6 months. At 12 months, 77 patients (72.0%) achieved pain response: 35 of 42 ultrasound-positive patients (83.3%) and 42 of 65 ultrasound-negative patients (64.6%). Ultrasound-positive status was associated with higher odds of pain response after multivariable adjustment (adjusted odds ratio [OR], 3.69; 95% confidence interval [CI], 1.28–10.67; p = 0.016). Firth bias-reduced logistic regression yielded a similar estimate (OR, 3.32; 95% profile-likelihood CI, 1.26–9.81; p = 0.015). Conclusions: Preoperative ultrasonographic evidence of nerve entrapment was associated with more favorable postoperative pain outcomes after nerve decompression in patients with PDPN. Its potential prognostic value requires prospective validation.

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Cite

BibTeXRIS
BibTeX
@article{zhang2026association,
  title = {{Association Between Ultrasonographic Evidence of Nerve Entrapment and Pain Outcomes After Nerve Decompression in Painful Diabetic Peripheral Neuropathy}},
  author = {Ze Zhang and Qi Wang and Zhenxuan Gao and Wenqiang Yang and Shuguang Cai and Quanyu Jin and Jiaxin Liu and Chenchen Kong and Abudurezhake Aerman and Lei Kou and Li Zhang},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15208029},
  url = {https://www.mdpi.com/2077-0383/15/20/8029},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Association Between Ultrasonographic Evidence of Nerve Entrapment and Pain Outcomes After Nerve Decompression in Painful Diabetic Peripheral Neuropathy
AU  - Ze Zhang
AU  - Qi Wang
AU  - Zhenxuan Gao
AU  - Wenqiang Yang
AU  - Shuguang Cai
AU  - Quanyu Jin
AU  - Jiaxin Liu
AU  - Chenchen Kong
AU  - Abudurezhake Aerman
AU  - Lei Kou
AU  - Li Zhang
PY  - 2026
DA  - 2026/10/01
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15208029
UR  - https://www.mdpi.com/2077-0383/15/20/8029
AB  - Objective: To evaluate whether preoperative ultrasonographic evidence of nerve entrapment is associated with pain relief after lower-limb peripheral nerve decompression in patients with painful diabetic peripheral neuropathy (PDPN). Methods: This single-center retrospective cohort study included 110 consecutive patients with PDPN who underwent bilateral lower-limb peripheral nerve decompression between February 2023 and June 2024. After three patients were lost to follow-up, 107 were analyzed. Preoperative ultrasonography assessed the bilateral common peroneal and tibial nerves. Patients were classified as ultrasound-positive if at least one examined nerve met the specified focal entrapment criteria and as ultrasound-negative otherwise. Numeric rating scale (NRS) scores were recorded preoperatively and at 7 days, 6 months, and 12 months after surgery. A ≥50% reduction in NRS score at 12 months was defined as pain response. Analysis of covariance and multivariable logistic regression were performed. Results: Ultrasonographic evidence of focal entrapment in at least one examined common peroneal or tibial nerve was identified in 42 patients (39.3%). Mean NRS scores decreased from 7.9 preoperatively to 2.7, 2.5, and 2.7 at 7 days, 6 months, and 12 months, respectively (all Holm-adjusted p < 0.001). After adjustment for baseline NRS score, the ultrasound-positive group had lower NRS scores at 7 days and 12 months than the ultrasound-negative group; the between-group difference was not statistically significant at 6 months. At 12 months, 77 patients (72.0%) achieved pain response: 35 of 42 ultrasound-positive patients (83.3%) and 42 of 65 ultrasound-negative patients (64.6%). Ultrasound-positive status was associated with higher odds of pain response after multivariable adjustment (adjusted odds ratio [OR], 3.69; 95% confidence interval [CI], 1.28–10.67; p = 0.016). Firth bias-reduced logistic regression yielded a similar estimate (OR, 3.32; 95% profile-likelihood CI, 1.26–9.81; p = 0.015). Conclusions: Preoperative ultrasonographic evidence of nerve entrapment was associated with more favorable postoperative pain outcomes after nerve decompression in patients with PDPN. Its potential prognostic value requires prospective validation.
SN  - 2077-0383
ER  -