UT Southwestern launches study of surgical option for treating diabetic, other neuropathies

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UT Southwestern launches study of surgical option for treating diabetic,

other neuropathies

Media Contact: Rian

russell.rian@...

DALLAS – July 10, 2008 – UT Southwestern Medical Center plastic surgeons

and specialists in diabetes, neurology, pain management and

rehabilitation are launching a cutting-edge study of peripheral nerve

surgery to alleviate long-standing pain and numbness in patients with

diabetic neuropathy.

Neuropathy is nerve-related pain, often associated with diabetes. The

risk of developing neuropathy increases the longer a person has

diabetes, and it is estimated that up to 40 percent of diabetics have

some form of neuropathy. UT Southwestern is one of a few U.S. medical

centers, and the only facility in North Texas, to offer surgery on

peripheral nerves, which originate from the spine.

“Patients with neuropathy are often told that the problem is

irreversible and that they cannot be helped,” says Dr. Shai Rozen,

assistant professor of plastic surgery. “Diabetic neuropathy is a

complex problem caused by multiple factors. We think pressure on nerves

may be one component responsible for the symptoms in certain patients.

This is very important to emphasize: Surgery may be helpful only in

patients we suspect have pressure on their nerves in addition to their

neuropathy and is not for all neuropathy patients.”

About one-third of patients with diabetic neuropathy have overlying

compression of certain nerves in the leg that may worsen the pain and

cause loss of sensation at the bottom of the foot. Several studies have

demonstrated that the nerves may increase in diameter in diabetic

patients. In this study, UT Southwestern investigators are hoping to

show that by releasing pressure from the specific nerves of these

patients, pain may be decreased and sensation improved.

“The concept of nerve compression in diabetics is not new,” Dr. Rozen

said. “Carpal tunnel syndrome is a medical term used to describe

compression of the median nerve at the wrist. It appears in

approximately 2 percent of the general population, but in 15 percent to

30 percent of patients with diabetes. The treatment of choice in these

patients, if conservative treatment has failed, is surgical nerve release.”

In addition to pain, patients suffering from diabetic neuropathy have

decreased sensation on the bottoms of their feet. Because they can

injure their feet without noticing it, many develop ulcerations. About

one out of every six patients with ulcers require amputations –

accounting for the nearly 100,000 amputations per year in the U.S.

because of diabetes.

“If we are able to restore at least protective sensation – that means

patients will feel it if they hit something with their foot – it may

decrease the amount of ulcers and eventual amputations in this high-risk

population,” Dr. Rozen said.

Peripheral nerves supply sensation and are responsible for activating

different muscles in the body. If these nerves are injured or

compressed, they may be responsible for pain, loss of sensation, or even

loss of function. Some of these problems may be helped by nerve surgery.

“Pain problems like these are not uncommon. The main problem is

education and awareness among patients and physicians alike that there

may be surgical solutions to some of these problems,” Dr. Rozen said.

“We all know patients who had surgery for a ‘pinched’ nerve in the back.

The concepts are very similar – relieve a nerve from pressure, repair it

or even cut it in certain cases, and the pain may be relieved.”

The study is funded through the Multidisciplinary Clinical

and Translational Pilot and Collaborative Study Initiative – Pilot Grant

Award Program and a gift from the Crowley Foundation.

UT Southwestern departments involved in the study include neurology,

endocrinology, physical medicine and rehabilitation, pain management and

plastic surgery.

Visit http://www.utsouthwestern.org/plasticsurgery for additional

information about UT Southwestern’s clinical services in plastic

surgery. Visit http://www.utsouthwestern.org/endocrinology for

additional information about UT Southwestern’s clinical services in

endocrinology.

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This news release is available on our World Wide Web home page at

www.utsouthwestern.edu/home/news/index.html

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ne Holden, MS, RD

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