Short-term spinal cord stimulation versus debridement for the treatment of diabetic foot: A retrospective cohort study

Background: This is the first study to evaluate the efficacy of short-term Spinal Cord Stimulation (st-SCS) versus debridement for treating Diabetic Foot Ulcers (DFU). Methods: We retrospectively analyzed records from DFU patients treated at our hospital. Patients were divided into two groups: 62 received st-SCS with debridement (SCS group), and 43 received only debridement (debridement group). We recorded ulcer area, Ankle-Brachial Index, sleep and life quality indices, foot temperature, and visual analog pain scale, and at 2 and 6 weeks post-operation, monitoring adverse events as well. Compared these indicators between the two groups, and changes in the SCS group were specifically analyzed at different time points. Results: Initially, both groups were comparable (P > 0.05). At 2 weeks postoperatively, the ulcer area reduction rate in the SCS group was higher than debridement group (24.37 % vs 12.77 %, P = 0.025), but this advantage disappeared by 6 weeks (P = 0.110). Compared to baseline, therapeutic indicators in the SCS group showed significant improvement at 2 weeks postoperatively and were significantly better than debridement group (P < 0.001). However, by 6 weeks postoperatively, all indicators except ulcer area had returned to baseline levels and showed no significant difference from the debridement group (P > 0.05). The amputation rate was higher in the debridement group (16.28 % vs 3.23 %, P = 0.036), and there were no significant differences in complications (P=0.132). Conclusion: St-SCS shows significant early benefits over debridement in ulcer healing, pain relief, circulation improvement, and lower amputation rates. However, these benefits did not persist at 6 weeks post-treatment. (c) 2024 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).