AI Article Synopsis
- This study analyzed the surgical outcomes of posterior decompression for cervical spondylotic myelopathy (CSM) in diabetic versus nondiabetic patients using data from 675 individuals across multiple centers.
- Diabetic patients had lower Japanese Orthopedic Association (JOA) scores before and after surgery compared to nondiabetic patients, indicating worse outcomes, although the improvement between the two groups was statistically similar.
- Despite the differences in scores, the pain relief (measured by the visual analog scale) was comparable between the two groups, suggesting that diabetes did not significantly affect pain outcomes after surgery for CSM.
Article Abstract
Study Design: Retrospective multicenter study.
Objective: The aim of this study was to identify the impact of diabetes on surgical outcomes of posterior decompression for cervical spondylotic myelopathy (CSM).
Summary Of Background Data: Although some previous studies have reported surgical outcomes of posterior decompression for CSM in diabetic patients, their results were inconsistent.
Methods: We included 675 patients with CSM who underwent posterior decompression. Patients were divided into diabetic (n = 140) and nondiabetic (n = 535) groups according to the diabetic criteria for glucose intolerance. Surgical outcomes as assessed by the Japanese Orthopedic Association (JOA) scores and visual analog scale (VAS) for neck pain were compared between groups. Subsequently, the functional outcomes of diabetic patients were compared between the mild (n = 131) and moderately severe (n = 9) groups. All patients were followed up for at least 1 year after surgery.
Results: Compared with the nondiabetic group, the diabetic group showed lower pre- and postoperative JOA scores (P = 0.025 and P = 0.001, respectively) and a lower JOA score recovery rate (RR) (P = 0.009). However, the preoperative-to-postoperative changes in JOA scores in the diabetic and nondiabetic groups were not significantly different (P = 0.988). Pre- and postoperative VAS for neck pain and postoperative reduction of neck pain were comparable between groups (P = 0.976, P = 0.913 and P = 0.688, respectively). Although statistical analysis was not performed due to the small underpowered sample size, functional outcomes assessed by the JOA score RR (43.3 ± 37.1% vs. 45.3 ± 33.9%) and preoperative-to-postoperative changes in JOA scores (3.0 ± 2.2 vs. 2.7 ± 2.5) were similar between the mild and moderately severe diabetes groups.
Conclusion: CSM patients with diabetes experienced improvements in neurological function and neck pain as a result of posterior decompression to the same extent seen in patients without diabetes.Level of Evidence: 3.
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| http://dx.doi.org/10.1097/BRS.0000000000003817 | DOI Listing |
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