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Link observed between diabetes, new cervical deformity after ASD surgery

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BOSTON — By the 2-year follow-up, nearly half of patients in a study who did not have cervical deformity prior to undergoing surgery for adult spinal deformity developed some cervical deformity, according to data presented here. 

Christopher P. Ames, MD, and members of the International Spine Study Group studied 215 patients with adult spinal deformity (ASD) who were operated on between 2009 and 2012 and prospectively enrolled in a large, multicenter database. The study was designed to quantify the incidence of new cervical deformity in this population.

Eighty-eight patients had complete 2-year follow up, as well as full-length radiographs that included the cervical spine and, therefore, met all the inclusion criteria, according to Ames, who presented the findings at the Congress of Neurological Surgeons Annual Meeting.

“A new onset cervical deformity following thoracolumbar adult deformity is relatively common,” Ames said. “It happens in about half the patients in 2 years. Independent predictors of postoperative cervical deformity include diabetes.”

Forty-two patients, or 47% of the study cohort, developed new onset cervical deformity within 2 years.

A univariate analysis showed, among other things, that the incidence of diabetes was 14.29% in patients who developed new cervical deformity compared with 2.17% in patients without cervical deformity.

Ames and colleagues also compared outcomes between patients with and without new cervical deformity using the Health Related Quality of Life (HRQL) score to assess any impact from the postsurgical changes.

“Significant improvement in HRQL scores occurred despite the development of new-onset cervical deformity and, therefore, its clinical significance remains unclear,” Ames said. — by Susan M. Rapp

Reference:

Soroceanu A. Paper #147. Presented at: Congress of Neurological Surgeons Annual Meeting; Oct. 18-22, 2014; Boston.

Disclosure: DePuy Synthes supports the International Spine Study Group.