Controlled diabetes before cervical spine surgery may improve outcomes

Controlling diabetes mellitus prior to undergoing degenerative cervical spine surgery can increase the odds for better outcomes and decreased costs, according to study findings.

Researchers retrospectively reviewed the Nationwide Inpatient Sample from 2002 to 2011 to identify patients who underwent cervical spine surgery for degenerative conditions. A total of 1,602,145 patients were identified, of which 213,360 patients (13.3%) had controlled diabetes mellitus (DM) and 10,548 had uncontrolled DM.

The researchers assessed patient demographics, surgical procedures, perioperative complications and postoperative outcomes to determine the impact of glycemic control on outcomes.

During the study period, the number of patients with controlled and uncontrolled diabetes who underwent degenerative cervical spine surgery increased significantly, according to the researchers.

Patients with uncontrolled diabetes were found to have significantly increased odds of respiratory, cardiac and genitourinary complications, as well as increased risk of postoperative infection and pulmonary embolism.

Additionally, patients with uncontrolled DM had an increased risk for inpatient mortality and mean length of hospital stay.

Contrarily, patients with controlled DM had increased odds of perioperative complications, although not to the same degree, as well as increased costs and a one day longer mean hospital stay compared with patients with uncontrolled DM, according to the researchers.

Disclosure: NIH/NIAMS grant funds were received in support of this work.