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Spine Surgery Results in Diabetic Patients

Spine surgery is trickier for people with diabetes. Problems can be harder to diagnose. Nerve problems and diabetes medications can make the surgery more difficult. Often, people with diabetes have worse outcomes after spine surgery. Surgeons need to understand as much as they can about how a procedure will affect a diabetic patient.

This study looked at results of decompression surgery for lumbar spinal stenosis. Sixty-two diabetic patients were followed for one to six years. The control group was 62 patients who did not have diabetes. All patients were over 65. The diabetic group had more pain and weakness before surgery. More patients in the diabetic group also had other health problems before surgery. The authors note that depression was much higher in the diabetes group before surgery. This is important because depressed patients tend to report more pain.

After surgery, both groups had about the same pain relief. Both groups were better able to do daily activities. The control group saw improvement in more activities. Within the diabetes group, patients who needed insulin and those who didn't had the same outcomes.

However, the diabetes patients had many more complications during surgery. Sixty-seven percent had surgical complications, compared to 28 percent of the control group. There was also a big difference in patient satisfaction. In the diabetes group, 53 percent of the patients rated their results as satisfying. This compares to 78 percent in the control group. The diabetes group also had more additional surgeries to control pain.

All patients who reported dissatisfaction were more likely to report ongoing pain. The authors stress that pain relief is key to good outcomes after surgery. Overall, the authors conclude that decompression surgery can be effective in older diabetic patients.

References: Zeev Arinzon, et al. Outcomes of Decompression Surgery for Lumbar Spinal Stenosis in Elderly Diabetic Patients. In European Spine Journal. February 2004. Vol. 13. No. 1. Pp. 32-37.

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