• Satoshi Nori, Narihito Nagoshi, Kenji Yoshioka, Kenya Nojiri, Yuichiro Takahashi, Kentaro Fukuda, Takeshi Ikegami, Hideaki Yoshida, Takahito Iga, Osahiko Tsuji, Satoshi Suzuki, Eijiro Okada, Mitsuru Yagi, Masaya Nakamura, Morio Matsumoto, Kota Watanabe, Ken Ishii, and Junichi Yamane.
• Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
• Spine. 2021 Apr 1; 46 (7): 433-439.

Study DesignRetrospective multicenter study.ObjectiveThe aim of this study was to identify the impact of diabetes on surgical outcomes of posterior decompression for cervical spondylotic myelopathy (CSM).Summary Of Background DataAlthough some previous studies have reported surgical outcomes of posterior decompression for CSM in diabetic patients, their results were inconsistent.MethodsWe included 675 patients with CSM who underwent posterior decompression. Patients were divided into diabetic (n = 140) and nondiabetic (n = 535) groups according to the diabetic criteria for glucose intolerance. Surgical outcomes as assessed by the Japanese Orthopedic Association (JOA) scores and visual analog scale (VAS) for neck pain were compared between groups. Subsequently, the functional outcomes of diabetic patients were compared between the mild (n = 131) and moderately severe (n = 9) groups. All patients were followed up for at least 1 year after surgery.ResultsCompared with the nondiabetic group, the diabetic group showed lower pre- and postoperative JOA scores (P = 0.025 and P = 0.001, respectively) and a lower JOA score recovery rate (RR) (P = 0.009). However, the preoperative-to-postoperative changes in JOA scores in the diabetic and nondiabetic groups were not significantly different (P = 0.988). Pre- and postoperative VAS for neck pain and postoperative reduction of neck pain were comparable between groups (P = 0.976, P = 0.913 and P = 0.688, respectively). Although statistical analysis was not performed due to the small underpowered sample size, functional outcomes assessed by the JOA score RR (43.3 ± 37.1% vs. 45.3 ± 33.9%) and preoperative-to-postoperative changes in JOA scores (3.0 ± 2.2 vs. 2.7 ± 2.5) were similar between the mild and moderately severe diabetes groups.ConclusionCSM patients with diabetes experienced improvements in neurological function and neck pain as a result of posterior decompression to the same extent seen in patients without diabetes.Level of Evidence: 3.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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