19 Harley St, London, W1G 9QJ, UK

The impact of diabetes on the outcomes of surgical and nonsurgical treatment of patients in the spine patient outcomes research trial

STUDY DESIGN: A secondary analysis comparing diabetic patients with nondiabetic patients enrolled in the Spine Patient Outcomes Research Trial (SPORT). OBJECTIVE: To compare surgical outcomes and complications between diabetic and nondiabetic spine patients. SUMMARY OF BACKGROUND DATA: Patients with diabetes are predisposed to comorbidities that may confound the diagnosis and treatment of patients with spinal disorders. METHODS: Baseline characteristics and outcomes of 199 patients with diabetes were compared with those of the nondiabetic population in a total of 2405 patients enrolled in the Spine Patient Outcomes Research Trial for the diagnoses of intervertebral disc herniation (IDH), spinal stenosis (SpS), and degenerative spondylolisthesis (DS). Primary outcome measures include the 36-Item Short Form Health Survey (SF-36) Health Status questionnaire and the Oswestry Disability Index. RESULTS: Patients with diabetes were significantly older and had a higher body mass index than nondiabetic patients. Comorbidities, including hypertension, stroke, cardiovascular disease, and joint disease, were significantly more frequent in diabetic patients than in nondiabetic patients. Patients with diabetes and IDH did not make significant gains in pain and function with surgical intervention relative to diabetic patients who underwent nonoperative treatment. Diabetic patients with SpS and DS experienced significantly greater improvements in pain and function with surgical intervention when compared with nonoperative treatment. Among those who had surgery, nondiabetic patients with SpS achieved marginally significantly greater gains in function than their diabetic counterparts (SF-36 physical function, P = 0.062). Among patients who had surgery for DS, diabetic patients did not have as much improvement in pain or function as did the nondiabetic population (SF-36 bodily pain, P = 0.003; physical function, P = 0.002). Postoperative complications were more prevalent in patients with diabetes than in nondiabetic patients with SpS (P = 0.002). There was an increase in postoperative (P = 0.028) and intraoperative (P = 0.029) blood replacement in DS patients with diabetes. CONCLUSION: Diabetic patients with SpS and DS benefited from surgery, though older SpS patients with diabetes have more postoperative complications. IDH patients with diabetes did not benefit from surgical intervention

Keywords : Adult,Aged,analysis,blood,Body Mass Index,Comorbidity,complications,Diabetes Complications,diagnosis,Disability Evaluation,Female,Follow-Up Studies,Health Status,Humans,Hypertension,Intervertebral Disc,Intervertebral Disc Displacement,Kaplan-Meier Estimate,Male,methods,Middle Aged,Outcome Assessment (Health Care),Pain,Patients,Postoperative Complications,secondary,Spinal Diseases,Spinal Stenosis,Spine,Spondylolisthesis,Stroke,surgery,Surveys and Questionnaires,Time Factors,Universities,, Impact,Diabetes, pain medicine specialists

Date of Publication : 2011 Feb 15

Authors : Freedman MK;Hilibrand AS;Blood EA;Zhao W;Albert TJ;Vaccaro AR;Oleson CV;Morgan TS;Weinstein JN;

Organisation : Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA. mitchell.freedman@rothmaninstitute.com

Journal of Publication : Spine (Phila Pa 1976 )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21270715

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Trends in the diagnosis and treatment of pediatric primary spinal cord tumors | Migraine clinic london

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810