1. Two-Year Clinical and Radiological Outcomes in Patients With Diabetes Undergoing Single-Level Anterior Cervical Discectomy and Fusion
- Author
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Branko Kopjar, Paul M. Arnold, Rick C. Sasso, Alexander R. Vaccaro, Benoit Goulet, Robert F. Heary, Michael Janssen, and Michael G. Fehlings
- Subjects
medicine.medical_specialty ,Visual Analog Scale ,Visual analogue scale ,cervical radiculopathy ,Anterior cervical discectomy and fusion ,Investigational device exemption ,Single level ,prognostic study ,Diabetes mellitus ,Secondary analysis ,medicine ,Orthopedics and Sports Medicine ,In patient ,business.industry ,Neck Disability Index ,Original Articles ,medicine.disease ,degenerative disc disorder ,Surgery ,Short Form 36 ,anterior cervical discectomy and fusion (ACDF) ,Radiological weapon ,diabetes mellitus ,Neurology (clinical) ,business - Abstract
Study Design: Secondary analysis of data from the multicenter, randomized, parallel-controlled Food and Drug Administration (FDA) investigational device exemption study. Objective: Studies on outcomes following anterior cervical discectomy and fusion (ACDF) in individuals with diabetes are scarce. We compared 24-month radiological and clinical outcomes in individuals with and without diabetes undergoing single-level ACDF with either i-FACTOR or local autologous bone. Methods: Between 2006 and 2013, 319 individuals with single-level degenerative disc disease (DDD) and no previous fusion at the index level underwent ACDF. The presence of diabetes determined the 2 cohorts. Data collected included radiological fusion evaluation, neurological outcomes, Neck Disability Index (NDI), Visual Analog Scale (VAS) scores, and the 36-Item Short Form Survey Version 2 (SF-36v2) Physical and Mental component summary scores. Results: There were 35 individuals with diabetes (11.1%; average body mass index [BMI] = 32.99 kg/m2; SD = 5.72) and 284 without (average BMI = 28.32 kg/m2; SD = 5.67). The number of nondiabetic smokers was significantly higher than diabetic smokers: 73 (25.70%) and 3 (8.57%), respectively. Preoperative scores of NDI, VAS arm pain, and SF-36v2 were similar between the diabetic and nondiabetic participants at baseline; however, VAS neck pain differed significantly between the cohorts at baseline ( P = .0089). Maximum improvement for NDI, VAS neck and arm pain, and SF-36v2 PCS and MCS scores was seen at 6 months in both cohorts and remained stable until 24 months. Conclusions: ACDF is effective for cervical radiculopathy in patients with diabetes. Diabetes is not a contraindication for patients requiring single-level surgery for cervical DDD.
- Published
- 2020