2023 Fiscal Year Final Research Report
Clinical Research on tibial nerve decompression for tarsal tunnel syndrome in diabetic patients (preventive strategy to avoid major amputation)
| Project/Area Number |
21K09794
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 56070:Plastic and reconstructive surgery-related
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| Research Institution | Saga University |
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Principal Investigator |
Uemura Tetsuji 佐賀大学, 医学部附属病院, 准教授 (90325621)
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| Co-Investigator(Kenkyū-buntansha) |
渡邊 英孝 佐賀大学, 医学部, 助教 (10404203)
中馬 隆広 佐賀大学, 医学部, 助教 (60911196)
楊井 哲 佐賀大学, 医学部, 病院講師 (80407551)
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| Project Period (FY) |
2021-04-01 – 2024-03-31
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| Keywords | 糖尿病性足病変 / 足根管症候群 / 絞扼性神経障害 / Tinel様兆候 |
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| Outline of Final Research Achievements |
Data were compiled, reviewed, and analyzed for prospective and interventional outcomes of all 31 feet in which patients diagnosed with tarsal tunnel syndrome in diabetic foot disease underwent a minimally invasive full endoscopic approach to tibial nerve neurolysis in diabetic foot neuropathy with the USE system between March 2015 and November 2023.
Preoperative complaints of numbness, positive Tinel-like signs, sensory disturbance, and abnormal motor nerve conduction velocity were present in all 31 patients. 6-month results were evaluated. There was a significant difference in the mean mTCNS values preoperatively and 6 months postoperatively, and all 31 foot evaluation scores improved postoperatively. This study allowed us to identify strangulated nerve symptoms at the tarsal tunnel among diabetic patients and to validate the efficacy of tibial nerve neurolysis for strangulated neuropathy at the level of the tarsal tunnel.
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| Free Research Field |
形成外科
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| Academic Significance and Societal Importance of the Research Achievements |
不可逆的とされていた糖尿病性経障害の中から足根管症候群と診断され、神経障害が改善可能な母集団が存在することが明らかとなった。低侵襲な内視鏡外科的治療により神経の絞扼を改善することができれば足部の潰瘍発生予防の新たな可能性が生まれる。糖尿病患者は全世界で急増しており、高齢化社会を迎える日本において、健康寿命を推進し、糖尿病患者のQOLを尊重し、死ぬ直前まで自分の足で歩く生活環境を目指すために足の感覚神経障害の改善が潰瘍発生予防に繋がり、大切断を回避できると考える。今後、更なる研究は、糖尿病患者における足根管症候群の疫学調査を行い、本疾患を呈する多くの患者を抽出することである。
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