Krista Garrod, Scott LaJoie A, Steve McCabe and Lee Dellon A
The historical consequences of diabetic neuropathy are loss of sensibility with its consequences; foot ulceration and amputation. The purpose of this decision-tree analysis is to evaluate the effectiveness of medical management versus surgical decompression in patients presenting with diabetic neuropathy and superimposed chronic tibial and peroneal nerve compressions. A decision-tree analytic approach was utilized to achieve a reasonable efficacy estimate. The study is limited by the uncertainty associated with utility values, probabilities, and complication rates. Other limitations to this model include lack of randomized controlled trial data, and assumed patient compliance with either the medical or surgical treatment strategies. Based upon the available evidence from the literature, this model demonstrates the potential advantage of the strategy of decompression surgery for treatment of diabetic neuropathy with superimposed tibial and peroneal nerve compressions.
