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Decompressive surgery for treating nerve damage in leprosy

Van Veen NHJ, Schreuders TAR, Theuvenet WJ, Agrawal A, Richardus JH
Published Online: 
12 December 2012

Leprosy is a chronic infectious disease. Leprosy bacteria cause damage to skin and peripheral nerves which may result in nerve function impairment and disability. Decompressive surgery is used for treating nerve damage although its effect is uncertain. Two randomised controlled trials (RCTs) were included in the review and examined the added benefit of surgery over prednisolone for treatment of nerve damage of less than six months duration. Both trials were at high risk of bias. Two years from the start there was very low quality evidence of no significant difference in nerve function improvement between people treated with surgery plus prednisolone or with prednisolone alone. Adverse effects of decompressive surgery were not adequately described. No additional trials were identified when searches were updated in 2010 and 2012. Decompressive surgery is used for treating nerve damage in leprosy but the available evidence from RCTs is of very low quality and does not show a significant added benefit of surgery over steroid treatment alone. Well-designed RCTs are needed to establish the effectiveness of the combination of surgery and medical treatment compared to medical treatment alone.

This record should be cited as: 
Van Veen NHJ, Schreuders TAR, Theuvenet WJ, Agrawal A, Richardus JH. Decompressive surgery for treating nerve damage in leprosy. Cochrane Database of Systematic Reviews 2012, Issue 12. Art. No.: CD006983. DOI: 10.1002/14651858.CD006983.pub3
Assessed as up to date: 
15 October 2012