Department of Orthopaedic Surgery and Spinal Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
The University of Tokyo Spine Group (UTSG), Tokyo, Japan.
Sci Rep. 2022 Jun 11;12(1):9684. doi: 10.1038/s41598-022-13838-2.
Although patients with diabetes reportedly have more peripheral neuropathy, the impacts of diabetes on postoperative recovery in pain and patient-reported outcome measures (PROMs) after laminoplasty for cervical spondylotic myelopathy (CSM) is not well characterized. The authors aimed to elucidate the effects of diabetes on neck/arm/hand/leg/foot pain and PROMs after laminoplasty CSM. The authors retrospectively reviewed 339 patients (82 with diabetes and 257 without) who underwent laminoplasty between C3 and C7 in 11 hospitals during April 2017 -October 2019. Preoperative Numerical Rating Scale (NRS) scores in all five areas, the Short Form-12 Mental Component Summary, Euro quality of life 5-dimension, Neck Disability Index, and the Core Outcome Measures Index-Neck) were comparable between the groups. The between-group differences were also not significant in NRS scores and PROMs one year after surgery. The change score of NRS hand pain was larger in the diabetic group than the nondiabetic group. The diabetic group showed worse preoperative score but greater improvement in the Short Form-12 Physical Component Summary than the nondiabetic group, following comparable score one year after surgery. These data indicated that the preoperative presence of diabetes, at least, did not adversely affect pain or PROMs one year after laminoplasty for CSM.
尽管有报道称糖尿病患者更容易出现周围神经病变,但糖尿病对颈椎脊髓病(CSM)患者行椎板成形术后疼痛和患者报告的结果测量(PROMs)恢复的影响尚未得到充分描述。作者旨在阐明糖尿病对颈椎管狭窄后路减压术后颈/臂/手/腿/脚疼痛和 PROMs 的影响。作者回顾性分析了 2017 年 4 月至 2019 年 10 月期间在 11 家医院接受 C3-C7 椎板成形术的 339 例患者(82 例合并糖尿病,257 例无糖尿病)。所有 5 个区域的术前数字评定量表(NRS)评分、短格式 12 项健康调查量表精神成分摘要、欧洲生活质量 5 维量表、颈部残疾指数和核心结局测量指标-颈部)在两组之间均具有可比性。术后 1 年,两组间 NRS 评分和 PROMs 之间的差异也无统计学意义。糖尿病组的 NRS 手部疼痛评分变化大于非糖尿病组。与非糖尿病组相比,糖尿病组术前评分较差,但术后 1 年时短格式 12 项健康调查量表生理成分摘要评分改善更大,术后评分相当。这些数据表明,CSM 患者至少在术前存在糖尿病并不会对术后 1 年的疼痛或 PROMs 产生不利影响。