Afsharian Tahmineh, Azhari Shirzad, Mostafazadeh Babak
Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Forensic Medicine and Toxicology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Asian J Neurosurg. 2017 Jul-Sep;12(3):424-427. doi: 10.4103/1793-5482.175623.
Poorer postoperative outcome is suggested after repairing surgery in diabetic patients with lumbar spinal stenosis in comparison with nondiabetic patients. The present study aimed to compare the clinical outcome of surgery for lumbar spinal stenosis and diabetic and nondiabetic patients to highlight the effect of diabetes on prognosis of this surgical procedure.
This prospective cohort study is conducted on 25 diabetic patients with lumbar spinal stenosis who were candidate for surgical treatment. A gender, age, and body mass index-matched group including 30 nondiabetic patients with lumbar spinal stenosis was considered as the control. The clinical condition of the patients was assessed based on oswestry disability index (ODI) before and immediately after surgery.
There was no difference in baseline ODI index between diabetes and diabetes group (73.68 ± 18.89 vs. 71.20 ± 18.27, = 0.625), whereas postprocedure ODI was significantly higher in diabetic patients than in nondiabetic group (54.32 ± 19.03 vs. 29.47 ± 18.75, < 0.001). The multivariable logistic regression analysis could show a difference in postoperative ODI between diabetic and nondiabetic patients with the presence of baseline variables as the confounders (beta = -24.509, < 0.001).
Lower improvement in physical ability is expected in diabetic patients after surgery for lumbar spinal stenosis when compared to nondiabetes patients.
与非糖尿病患者相比,糖尿病合并腰椎管狭窄症患者行修复手术后的术后预后较差。本研究旨在比较腰椎管狭窄症手术治疗糖尿病患者与非糖尿病患者的临床疗效,以突出糖尿病对该手术预后的影响。
本前瞻性队列研究对25例拟行手术治疗的糖尿病合并腰椎管狭窄症患者进行。将30例年龄、性别和体重指数匹配的非糖尿病腰椎管狭窄症患者作为对照组。根据Oswestry功能障碍指数(ODI)在手术前和手术后即刻评估患者的临床状况。
糖尿病组与非糖尿病组基线ODI指数无差异(73.68±18.89 vs. 71.20±18.27,P = 0.625),而糖尿病患者术后ODI显著高于非糖尿病组(54.32±19.03 vs. 29.47±18.75,P < 0.001)。多变量逻辑回归分析显示,在存在基线变量作为混杂因素的情况下,糖尿病患者与非糖尿病患者术后ODI存在差异(β=-24.509,P < 0.001)。
与非糖尿病患者相比,糖尿病患者腰椎管狭窄症手术后身体能力改善程度较低。