title: Acute Improvement in Intraoperative EMG Following Common Fibular Nerve Decompression in Patients with Symptomatic Diabetic Sensorimotor Peripheral Neuropathy: 1. EMG Results.
abstract: Background and Study AimsElectromyographic (EMG) recordings of the fibularis longus (FL) and tibialis anterior (TA) muscles were performed intraoperatively during common fibular nerve (CFN) nerve decompression (ND) in patients with symptomatic diabetic sensorimotor peripheral neuropathy (DSPN) and clinical nerve compression.Materials and MethodsForty-six legs in 40 patients underwent surgical ND by external neurolysis; FL and TA muscles were monitored intraoperatively. Evoked EMGs were recorded just prior to and within 1 minute after ND.ResultsThirty-eight legs (82.6%) demonstrated EMG improvement 1 minute after ND. Sixty muscles (31 FL, 29 TA) were monitored, with 44 (73.3%) improving in EMG amplitude. Mean change in EMG amplitude represented a 73.6% improvement (p< 0.0001). Changes in EMG amplitudes correlated with visual analog scale pain improvement (p= 0.03).ConclusionThis is the first report of acute changes in objective EMG responses during ND of CFN in DSPN patients and demonstrates that patients with symptomatic DSPN and clinical nerve entrapment have latent but functional axons that surgical ND can improve immediately.
authors.affiliation: Anderson Podiatry Center for Nerve Pain, Fort Collins, Colorado, United States.
authors.forename: James C
authors.initials: JC
authors.lastname: Anderson
authors.affiliation: Northeast Wyoming Wound Care Center, Sheridan, Wyoming, United States.
authors.forename: D Scott
authors.initials: DS
authors.lastname: Nickerson
authors.affiliation: Health and Exercise Science, Colorado State University, Fort Collins, Colorado, United States.
authors.forename: Brian L
authors.initials: BL
authors.lastname: Tracy
authors.affiliation: Health and Exercise Science, Colorado State University, Fort Collins, Colorado, United States.
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Paxton
authors.affiliation: Medtronic Vascular Inc. New Therapy Development, Jacksonville, Florida, United States.
authors.forename: Dwayne S
authors.initials: DS
authors.lastname: Yamasaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical; D003929:Diabetic Neuropathies / Q000503:physiopathology / Q000601:surgery*; D004576:Electromyography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D018482:Muscle, Skeletal / Q000294:innervation; D009408:Nerve Compression Syndromes / Q000503:physiopathology / Q000601:surgery*; D010543:Peroneal Nerve / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome