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Results of surgery for spondylotic myelopathy unaffected by diabetes, study finds

Issue: December 2011

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CHICAGO — Diabetes does not appear to impact the outcomes of surgery for patients undergoing treatment of symptomatic spondylotic myelopathy , according to a study presented here at the 2011 Annual Meeting of the North American Spine Society .

“If diabetic patients come in with myelopathy and you are hesitant to operate on them because they have diabetes, you should consider those patients could do just as well [as patients without diabetes] and have significant improvements,” study investigator Paul M. Arnold, MD, said during his presentation. “We recommend surgical management, all other things being equal.”

Arnold and his team performed a multicenter, controlled cohort study of 278 patients from 12 centers who displayed clinically symptomatic cervical spondylotic myelopathy. Arnold reported that 42 of these patients (15%) had diabetes.

Using outcome measures including a modified Japanese Orthopedic Association score (mJOA), Nurick Score, SF36v2 and the Neck Disability Index, Arnold and colleagues ran a comparison between patients with diabetes and those who did not have the condition.

The investigators noted that patients with diabetes were older, less likely to smoke and more likely to be on social security. They also presented with a higher Nurick Grade than those without diabetes (4.4 versus 4.1). However, Nurick said that the investigators found no differences between the groups for preoperative mJOA and SF36v2 scores.

Ultimately, Arnold noted, that patients with diabetes exhibited improvement just as significant as those without diabetes during a span of 12 months. Adjusting for numerous baseline characteristics, he added, did not affect the stability of the findings.

Reference:

• Kopjar B, Arnold P, Fehlings M, et al. Impact of diabetes on symptoms and treatment outcomes in patients with cervical spondylotic myelopathy: The results of the AOSPine North America multicenter prospective study. Paper #129. Presented at the 2011 Annual Meeting of the North America Spine Society. Nov. 2-5. Chicago.
• Disclosure: Arnold has a private investment in Z-plasty. He is also a consultant for Stryker Spine, Theken Spine, Fziomed, K2M, Medtronic, AOSpine North America and ApaTech. He is on the Board of Directors for AOSpine North America.

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