The peripheral nerves of patients with diabetes are often pathologically swollen, which results in entrapment at places of anatomical narrowing. This results in nerve dysfunction. Surgical treatment of compression neuropathies in the lower extremities (lower extremity nerve decompression (LEND)) results in relief of symptoms and gain in peripheral nerve function, which may lead to less sensory loss (short term) and less associated detrimental effects including foot ulceration and amputations, and lower costs (long term). The aim of the DeCompression trial is to evaluate the effectiveness and (cost-)effectiveness of surgical decompression of compressed lower extremity nerves (LEND surgery) compared with patients treated with conventional (non-surgical) care.
Patients will be followed for four years to assess differences in quality of life, sensory deficiencies, the occurrence of wounds/amputations, and corporal balance. Additionally, we want to investigate the (cost)effectiveness of decompression surgery compared to non-surgical care as we hypothesize that wounds and amputations can be prevented by decompressions. During the inclusion phase of this trial, we screened almost 1000 patients with diabetes and complaints of neuropathy. This makes it possible for us to evaluate the sensitivity of screening tools and hereby improve the selection of patients for decompression surgery.
Currently, we finalized the inclusion period, and we are currently collecting follow-up data to assess the primary and secondary outcomes.
The trial is subsidized by ZonMw.