Comparison of spinal deformity surgery in patients with Non-Insulin-Dependent Diabetes Mellitus (NIDDM) versus controls

Woojin Cho, Lawrence G. Lenke, Keith H. Bridwell, Ian G. Dorward, Naoki Shoda, Christine R. Baldus, Samuel K. Cho, Matthew M. Kang, Lukas P. Zebala, Joshua M. Pahys, Linda A. Koester

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

STUDY DESIGN. A retrospective review. OBJECTIVE. To quantify the exact impact of non-insulin-dependent diabetes mellitus (NIDDM) on operative complications and additional surgeries associated with spinal deformity surgery. SUMMARY OF BACKGROUND DATA. There are many references supporting diabetes mellitus (DM) as one of the major risk factors for perioperative complications in spinal surgery. However, the results vary depending on the type of DM, suggesting that insulin-dependent DM causes more complications than NIDDM, which is far more prevalent in the adult population with spinal deformity. METHODS. Among 5119 adult patients (older than 40 yr) with deformities, 23 patients with NIDDM and 23 control (group C) patients with a minimum 2-year follow-up were selected. Both groups were matched for age at surgery, sex, body mass index, number of comorbidities, smoking history, current and prior fusion levels, estimated blood loss, and the amount of transfusion. Pre- and final Scoliosis Research Society (SRS) scores and Oswestry Disability Index (ODI), number of perioperative complications, and additional surgeries were compared. Within the group with NIDDM, patients with (+) or without (-) complications were compared in terms of postoperative glucose control. RESULTS. There were no significant differences in the number of major or minor complications or additional surgeries between the 2 groups. There was no significant difference in postoperative glucose control with the NIDDM group (+) and (-). Group C reported significantly improved scores at final follow-up in all SRS domains and ODI. The group with NIDDM reported improvement in all domains except for the mental health and pain domains. However, there were no significant differences between the group with NIDDM and group C in terms of SRS and ODI scores preoperatively and postoperatively. CONCLUSION. Contrary to traditional thinking, properly selected NIDDM was not a significant risk factor for perioperative complications or additional surgeries in adult patients with spinal deformities.

Original languageEnglish (US)
JournalSpine
Volume37
Issue number16
DOIs
StatePublished - Jul 15 2012
Externally publishedYes

Fingerprint

Type 2 Diabetes Mellitus
Scoliosis
Diabetes Mellitus
Research
Glucose
Type 1 Diabetes Mellitus
Comorbidity
Mental Health
Body Mass Index
Research Design
Smoking
History
Pain
Control Groups
Population

Keywords

  • additional surgery
  • complications
  • non-insulin-dependent diabetes mellitus (NIDDM)
  • spinal deformity surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Comparison of spinal deformity surgery in patients with Non-Insulin-Dependent Diabetes Mellitus (NIDDM) versus controls. / Cho, Woojin; Lenke, Lawrence G.; Bridwell, Keith H.; Dorward, Ian G.; Shoda, Naoki; Baldus, Christine R.; Cho, Samuel K.; Kang, Matthew M.; Zebala, Lukas P.; Pahys, Joshua M.; Koester, Linda A.

In: Spine, Vol. 37, No. 16, 15.07.2012.

Research output: Contribution to journalArticle

Cho, W, Lenke, LG, Bridwell, KH, Dorward, IG, Shoda, N, Baldus, CR, Cho, SK, Kang, MM, Zebala, LP, Pahys, JM & Koester, LA 2012, 'Comparison of spinal deformity surgery in patients with Non-Insulin-Dependent Diabetes Mellitus (NIDDM) versus controls', Spine, vol. 37, no. 16. https://doi.org/10.1097/BRS.0b013e31824edf42
Cho, Woojin ; Lenke, Lawrence G. ; Bridwell, Keith H. ; Dorward, Ian G. ; Shoda, Naoki ; Baldus, Christine R. ; Cho, Samuel K. ; Kang, Matthew M. ; Zebala, Lukas P. ; Pahys, Joshua M. ; Koester, Linda A. / Comparison of spinal deformity surgery in patients with Non-Insulin-Dependent Diabetes Mellitus (NIDDM) versus controls. In: Spine. 2012 ; Vol. 37, No. 16.
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abstract = "STUDY DESIGN. A retrospective review. OBJECTIVE. To quantify the exact impact of non-insulin-dependent diabetes mellitus (NIDDM) on operative complications and additional surgeries associated with spinal deformity surgery. SUMMARY OF BACKGROUND DATA. There are many references supporting diabetes mellitus (DM) as one of the major risk factors for perioperative complications in spinal surgery. However, the results vary depending on the type of DM, suggesting that insulin-dependent DM causes more complications than NIDDM, which is far more prevalent in the adult population with spinal deformity. METHODS. Among 5119 adult patients (older than 40 yr) with deformities, 23 patients with NIDDM and 23 control (group C) patients with a minimum 2-year follow-up were selected. Both groups were matched for age at surgery, sex, body mass index, number of comorbidities, smoking history, current and prior fusion levels, estimated blood loss, and the amount of transfusion. Pre- and final Scoliosis Research Society (SRS) scores and Oswestry Disability Index (ODI), number of perioperative complications, and additional surgeries were compared. Within the group with NIDDM, patients with (+) or without (-) complications were compared in terms of postoperative glucose control. RESULTS. There were no significant differences in the number of major or minor complications or additional surgeries between the 2 groups. There was no significant difference in postoperative glucose control with the NIDDM group (+) and (-). Group C reported significantly improved scores at final follow-up in all SRS domains and ODI. The group with NIDDM reported improvement in all domains except for the mental health and pain domains. However, there were no significant differences between the group with NIDDM and group C in terms of SRS and ODI scores preoperatively and postoperatively. CONCLUSION. Contrary to traditional thinking, properly selected NIDDM was not a significant risk factor for perioperative complications or additional surgeries in adult patients with spinal deformities.",
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AU - Lenke, Lawrence G.

AU - Bridwell, Keith H.

AU - Dorward, Ian G.

AU - Shoda, Naoki

AU - Baldus, Christine R.

AU - Cho, Samuel K.

AU - Kang, Matthew M.

AU - Zebala, Lukas P.

AU - Pahys, Joshua M.

AU - Koester, Linda A.

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N2 - STUDY DESIGN. A retrospective review. OBJECTIVE. To quantify the exact impact of non-insulin-dependent diabetes mellitus (NIDDM) on operative complications and additional surgeries associated with spinal deformity surgery. SUMMARY OF BACKGROUND DATA. There are many references supporting diabetes mellitus (DM) as one of the major risk factors for perioperative complications in spinal surgery. However, the results vary depending on the type of DM, suggesting that insulin-dependent DM causes more complications than NIDDM, which is far more prevalent in the adult population with spinal deformity. METHODS. Among 5119 adult patients (older than 40 yr) with deformities, 23 patients with NIDDM and 23 control (group C) patients with a minimum 2-year follow-up were selected. Both groups were matched for age at surgery, sex, body mass index, number of comorbidities, smoking history, current and prior fusion levels, estimated blood loss, and the amount of transfusion. Pre- and final Scoliosis Research Society (SRS) scores and Oswestry Disability Index (ODI), number of perioperative complications, and additional surgeries were compared. Within the group with NIDDM, patients with (+) or without (-) complications were compared in terms of postoperative glucose control. RESULTS. There were no significant differences in the number of major or minor complications or additional surgeries between the 2 groups. There was no significant difference in postoperative glucose control with the NIDDM group (+) and (-). Group C reported significantly improved scores at final follow-up in all SRS domains and ODI. The group with NIDDM reported improvement in all domains except for the mental health and pain domains. However, there were no significant differences between the group with NIDDM and group C in terms of SRS and ODI scores preoperatively and postoperatively. CONCLUSION. Contrary to traditional thinking, properly selected NIDDM was not a significant risk factor for perioperative complications or additional surgeries in adult patients with spinal deformities.

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KW - additional surgery

KW - complications

KW - non-insulin-dependent diabetes mellitus (NIDDM)

KW - spinal deformity surgery

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