File
Authors
Tanishima, Shinji Department of Orthopedic Surgery, Faculty of Medicine, Tottori University Researchers DB
Mihara, Tokumitsu Department of Orthopedic Surgery, Faculty of Medicine, Tottori University Researchers DB
Tanida, Atsushi Department of Orthopedic Surgery, Faculty of Medicine, Tottori University
Takeda, Chikako Department of Orthopedic Surgery, Faculty of Medicine, Tottori University Researchers DB
Murata, Masaaki Department of Orthopaedic Surgery, Tottori Central Prefectural Hospital
Takahashi, Toshiaki Department of Orthopedic Surgery, Tottori Red Cross Hospital
Yamane, Koji Department of Orthopedic Surgery, Tottori Red Cross Hospital
Morishita, Tsugutake Department of Orthopedic Surgery, Tottori Municipal Hospital
Morio, Yasuo Department of Orthopedic Surgery, Misasa Onsen Hospital KAKEN
Ishii, Hiroyuki Department of Orthopedic Surgery, Misasa Onsen Hospital
Fukata, Satoru Department of Orthopedic Surgery, Misasa Onsen Hospital
Nanjo, Yoshiro Department of Orthopedic Surgery, Sanin Rosai Hospital
Hamamoto, Yuki Department of Orthopaedic Surgery, Matsue City Hospital
Dokai, Toshiyuki Department of Orthopedic Surgery, Masuda Red Cross Hospital
Nagashima, Hideki Department of Orthopedic Surgery, Faculty of Medicine, Tottori University Researchers DB KAKEN
Keywords
Neck
Spinal cord compression
Diabetes mellitus
Treatment outcome
Electromyography
Abstract
[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.
Publisher
Korean Society of Spine Surgery
Content Type
Journal Article
Link
ISSN
19761902
EISSN
19767846
NCID
AA12329596
Journal Title
ASIAN SPINE JOURNAL
Current Journal Title
ASIAN SPINE JOURNAL
Volume
13
Issue
3
Start Page
468
End Page
477
Published Date
2019-06
Publisher-DOI
Text Version
Publisher
Rights
(C) 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.
Citation
Tanishima Shinji, Mihara Tokumitsu, Tanida Atsushi, et al. Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study. ASIAN SPINE JOURNAL. 2019. 13(3). 468-477. doi:10.31616/asj.2018.0082
Department
Faculty of Medicine/Graduate School of Medical Sciences/University Hospital
Language
English
Web of Science Key ut
WOS:000470100900014