nerve decompression surgery outcome news

[Guest guest]

(Chuck, if I remember correctky, you were looking for info on this. Well, read

on... Gretchen)

Abstract from Ann Plast Surg. 2004 Dec;53(6):523-527.

Prognostic Ability of Tinel Sign in Determining Outcome for Decompression

Surgery in Diabetic and Nondiabetic Neuropathy.

Lee CH, Dellon AL.

From the *s Hopkins School of Medicine, Baltimore, land; and the

daggerDivision of Plastic Surgery and Department of Neurosurgery, s Hopkins

University, Baltimore, land, and Division of Plastic Surgery and Division of

Neurosurgery, and Department of Anatomy, University of Arizona, Tucson, Arizona.

During the past 12 years, 6 studies reported restoration of sensation and relief

of pain in the foot by decompression of the tibial nerve and its distal branches

in diabetic neuropathy. Although a positive Tinel sign related to favorable

outcomes in some of the reports, this relationship was not evaluated

specifically. In this study, the presence of the Tinel sign, positive or

negative, over the tibial nerve was recorded in 46 patients with diabetic

neuropathy and in 40 patients with idiopathic neuropathy. Outcomes were

dichotomized into either a good/excellent or failure/poor category.

Postoperative data were analyzed at 1 year. In diabetic neuropathy, the presence

of a positive Tinel sign had a sensitivity of 88%, a specificity of 50%, and a

positive predictive value of 88% in identifying patients who would have a

good/excellent outcome. In idiopathic neuropathy, the presence of a positive

Tinel sign had a sensitivity of 95%, a specificity of 56%, and a positive

predictive value of 93% in identifying patients who would have a good/excellent

outcome. It is concluded that a positive Tinel sign is a reliable indicator of

successful outcome from decompression of the tibial nerve in patients with

diabetes with symptomatic neuropathy, and in patients with symptomatic

idiopathic neuropathy.