• Peng-Bo Zhou, Hong-Tao Sun, and Min Bao.
• The First School of Clinical Medical, Lanzhou University, Lanzhou , Gansu , People's Republic of China.
• Neurosurgery. 2024 Aug 1; 95 (2): 313321313-321.

Background And ObjectivesSpinal cord stimulation (SCS) is an effective treatment for diabetic peripheral neuropathy. The purpose of this study was to investigate the effectiveness of SCS in the treatment of ischemic diabetic foot ulcers.MethodsIn this retrospective study, the SCS group comprised 102 patients with ischemic diabetic foot who were treated with SCS for foot ulcers and nonhealing wounds due to severe lower limb ischemia. The traditional debridement care (TDC) group comprised 104 patients with ischemic diabetic foot who received only TDC. Strict screening criteria were applied. The assignment of patients to either group depended solely on their willingness to be treated with SCS. Secondary end points were transcutaneous partial pressure of oxygen (PtcO 2 ), ankle-brachial index (ABI), and color Doppler of the lower limb arteries in the feet at 6 months and 12 months after treatment. The primary end point was the amputation.ResultsThe dorsal foot PtcO 2 and ABI of the patients in the SCS group were significantly improved at 6 months and 12 months postoperation ( P < .05). The therapeutic efficacy was significantly better than that of the TDC group over the same period of time ( P < .05). The degree of vasodilation of the lower limb arteries (ie, femoral, popliteal, posterior tibial, and dorsalis pedis arteries) on color Doppler was higher in the SCS group than in the TDC group ( P < .05). The odds ratios for total amputation at 6 and 12 months postoperatively in the SCS group were 0.45 (95% CI, 0.19-1.08) and 0.17 (95% CI, 0.08-0.37), respectively, compared with the TDC group.ConclusionSCS improved symptoms of lower limb ischemia in ischemic diabetic feet and reduced the rate of toe amputation by increasing PtcO 2 , ABI, and arterial vasodilation in the lower limbs.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Congress of Neurological Surgeons.

24 keywords...

hide…