Analysis of the safety and efficacy of single-stage spinal cord stimulation implantation under general anesthesia for high-risk diabetic feet.

Objective: To evaluate the safety and efficacy of implantation of a one-stage spinal cord stimulation (SCS) system under general anesthesia in patients with high-risk diabetic feet. Methods: A retrospective analysis was performed on 25 patients who were diagnosed with high-risk diabetic feet and who underwent implantation of an SCS system between January 2023 and May 2024. The procedure was conducted under general anesthesia with intraoperative electrophysiological monitoring. All patients were followed up for one year postoperatively. The outcomes, including pain intensity, foot skin temperature, dorsalis pedis artery flow velocity, and F-wave occurrence rate on electromyography, were assessed at baseline and at multiple time points after surgery. Additionally, postoperative complications such as infection, electrode displacement, and lead fracture, as well as rates of new ulcer formation, amputation, and mortality, were recorded. Results: All patients completed the 12-month follow-up period. The efficacy rate was 100% at 7 days postoperatively and 88% at 6 months, and the incidence of new ulcers at 1 year was 8%. Significant improvements in pain, foot skin temperature, and arterial flow velocity were observed within 7 days after implantation ( Conclusion: One-stage implantation of an SCS system under general anesthesia is safe and effective for managing high-risk diabetic feet. The system significantly alleviates pain, improves lower extremity perfusion, and enhances nerve conduction function. Notably, while vascular improvements occur rapidly, neurological recovery may require a longer duration of stimulation.