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Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study

STUDY DESIGN: Multicenter, prospective study. PURPOSE: To investigate the effects of diabetes mellitus (DM) on surgical outcomes in patients with cervical myelopathy. OVERVIEW OF LITERATURE: To date, few studies have investigated the influence of postoperative blood glucose or glycated hemoglobin (H...

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Autores principales: Tanishima, Shinji, Mihara, Tokumitsu, Tanida, Atsushi, Takeda, Chikako, Murata, Masaaki, Takahashi, Toshiaki, Yamane, Koji, Morishita, Tsugutake, Morio, Yasuo, Ishii, Hiroyuki, Fukata, Satoru, Nanjo, Yoshiro, Hamamoto, Yuki, Dokai, Toshiyuki, Nagashima, Hideki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547393/
https://www.ncbi.nlm.nih.gov/pubmed/30567422
http://dx.doi.org/10.31616/asj.2018.0082
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author Tanishima, Shinji
Mihara, Tokumitsu
Tanida, Atsushi
Takeda, Chikako
Murata, Masaaki
Takahashi, Toshiaki
Yamane, Koji
Morishita, Tsugutake
Morio, Yasuo
Ishii, Hiroyuki
Fukata, Satoru
Nanjo, Yoshiro
Hamamoto, Yuki
Dokai, Toshiyuki
Nagashima, Hideki
author_facet Tanishima, Shinji
Mihara, Tokumitsu
Tanida, Atsushi
Takeda, Chikako
Murata, Masaaki
Takahashi, Toshiaki
Yamane, Koji
Morishita, Tsugutake
Morio, Yasuo
Ishii, Hiroyuki
Fukata, Satoru
Nanjo, Yoshiro
Hamamoto, Yuki
Dokai, Toshiyuki
Nagashima, Hideki
author_sort Tanishima, Shinji
collection PubMed
description STUDY DESIGN: Multicenter, prospective study. PURPOSE: To investigate the effects of diabetes mellitus (DM) on surgical outcomes in patients with cervical myelopathy. OVERVIEW OF LITERATURE: To date, few studies have investigated the influence of postoperative blood glucose or glycated hemoglobin (HbA1c) levels on surgical outcomes. METHODS: The participants were patients who underwent surgery for the treatment of cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. The 61 cases were evaluated preoperatively and 1 year postoperatively using the Japanese Orthopaedic Association (JOA) scores and the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). The study variables included fasting blood glucose and HbA1c levels measured preoperatively and at 1 week, 4 weeks, and 1 year postoperatively; the F-wave conduction velocity, latency, rate of occurrence, and M-wave latency in the ulnar and tibial nerves were measured preoperatively and at 1 year postoperatively. The patients were divided into a group without diabetes (N group, 42 patients) and a group with diabetes (DM group, 19 patients). We then assessed the associations between the surgical outcomes and each of the study variables. RESULTS: JOA scores significantly improved in both groups; however, no significant between-group differences were found. There was no significant improvement in the JOACMEQ scores, which assessed cervical function, upper and lower limb function, and bladder function in both groups. We then subdivided the DM group into those with a good control of HbA1c after 1 year (DMG group, 12 patients) and those with HbA1c deterioration after 1 year (DMB group, seven patients), prior to comparing the surgical outcomes. The JOACMEQ scores for upper and lower limb function significantly improved in the DMG group (p<0.01). Compared with the DMB group, there were no significant increases in upper or lower limb function scores in the DMG group. CONCLUSIONS: Poor glycemic control might prevent postoperative functional recovery of the spinal cord.
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spelling pubmed-65473932019-06-17 Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study Tanishima, Shinji Mihara, Tokumitsu Tanida, Atsushi Takeda, Chikako Murata, Masaaki Takahashi, Toshiaki Yamane, Koji Morishita, Tsugutake Morio, Yasuo Ishii, Hiroyuki Fukata, Satoru Nanjo, Yoshiro Hamamoto, Yuki Dokai, Toshiyuki Nagashima, Hideki Asian Spine J Clinical Study STUDY DESIGN: Multicenter, prospective study. PURPOSE: To investigate the effects of diabetes mellitus (DM) on surgical outcomes in patients with cervical myelopathy. OVERVIEW OF LITERATURE: To date, few studies have investigated the influence of postoperative blood glucose or glycated hemoglobin (HbA1c) levels on surgical outcomes. METHODS: The participants were patients who underwent surgery for the treatment of cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. The 61 cases were evaluated preoperatively and 1 year postoperatively using the Japanese Orthopaedic Association (JOA) scores and the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). The study variables included fasting blood glucose and HbA1c levels measured preoperatively and at 1 week, 4 weeks, and 1 year postoperatively; the F-wave conduction velocity, latency, rate of occurrence, and M-wave latency in the ulnar and tibial nerves were measured preoperatively and at 1 year postoperatively. The patients were divided into a group without diabetes (N group, 42 patients) and a group with diabetes (DM group, 19 patients). We then assessed the associations between the surgical outcomes and each of the study variables. RESULTS: JOA scores significantly improved in both groups; however, no significant between-group differences were found. There was no significant improvement in the JOACMEQ scores, which assessed cervical function, upper and lower limb function, and bladder function in both groups. We then subdivided the DM group into those with a good control of HbA1c after 1 year (DMG group, 12 patients) and those with HbA1c deterioration after 1 year (DMB group, seven patients), prior to comparing the surgical outcomes. The JOACMEQ scores for upper and lower limb function significantly improved in the DMG group (p<0.01). Compared with the DMB group, there were no significant increases in upper or lower limb function scores in the DMG group. CONCLUSIONS: Poor glycemic control might prevent postoperative functional recovery of the spinal cord. Korean Society of Spine Surgery 2019-06 2018-12-21 /pmc/articles/PMC6547393/ /pubmed/30567422 http://dx.doi.org/10.31616/asj.2018.0082 Text en Copyright © 2019 by Korean Society of Spine Surgery This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Tanishima, Shinji
Mihara, Tokumitsu
Tanida, Atsushi
Takeda, Chikako
Murata, Masaaki
Takahashi, Toshiaki
Yamane, Koji
Morishita, Tsugutake
Morio, Yasuo
Ishii, Hiroyuki
Fukata, Satoru
Nanjo, Yoshiro
Hamamoto, Yuki
Dokai, Toshiyuki
Nagashima, Hideki
Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study
title Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study
title_full Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study
title_fullStr Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study
title_full_unstemmed Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study
title_short Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study
title_sort influence of diabetes mellitus on surgical outcomes in patients with cervical myelopathy: a prospective, multicenter study
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547393/
https://www.ncbi.nlm.nih.gov/pubmed/30567422
http://dx.doi.org/10.31616/asj.2018.0082
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