Safety And Efficacy Of Low Frequency(180-240Hz) Spinal Cord Electrical Stimulation In The Treatment Of Diabetes Foot

Objective: The aim of this study was to investigate the safety,feasibility,and clinical outcomes of low-frequency(180-240 Hz)spinal cord stimulation(SCS)in patients with diabetic foot.Methods: A total of 40 patients with diabetes foot peripheral neuropathy received lowfrequency spinal cord electrical stimulation implantation in Shengjing Hospital affiliated to China Medical University and were grouped according to Wagner classification.Four patients(10%)withdrew from the cohort study after spinal cord electrical stimulation test,and 36 patients(90%)received permanent SCS implantation and were followed up for 6months after operation.The clinical results were evaluated using objective examination methods,including nerve velocity conduction and vascular ultrasound of both lower extremities,as well as subjective assessment scale of patients,including quality of life scale(QOL-LC V2.0)and visual analogue scale of pain(VAS).The complications and side effects caused by the implantation of low-frequency electrical stimulation of spinal cord were also observed.Results: No deaths were reported in this cohort study.One patient(3%)withdrew from the study due to myocardial infarction,one patient(3%)due to cerebral infarction,one patient(3%)due to economic condition and one patient(3%)due to invalid test after spinal cord electrical stimulation test,and 36 patients(90%)underwent permanent SCS implantation.Compared with 6 months after operation,the quality of life scale(QOL-LC V2.0)and visual analogue scale of pain(VAS)of patients with diabetes foot peripheral neuropathy before operation(Wagner 1-5)were significantly improved in different degrees(P<0.05),and the nerve velocity conduction and vascular ultrasound of both lower limbs were improved in different degrees(P<0.05).Six patients(17%)showed discomfort to current stimulation with the change of body position(improved after adjusting stimulation parameters),and three patients(8%)relieved their previous history of constipation.No serious surgical adverse events were observed.Conclusion: The application of 180 to 240 Hz SCS can safely and effectively improve the symptoms of lower-extremity ischemia and pain in patients with different degrees of diabetic foot and significantly improve patient quality of life.