PMID- 34311136
OWN - NLM
STAT- MEDLINE
DCOM- 20211217
LR  - 20211217
IS  - 1878-8769 (Electronic)
IS  - 1878-8750 (Linking)
VI  - 154
DP  - 2021 Oct
TI  - Diabetes Mellitus Does Not Impact Achievement of a Minimum Clinically Important 
      Difference Following Anterior Cervical Discectomy and Fusion.
PG  - e520-e528
LID - S1878-8750(21)01081-0 [pii]
LID - 10.1016/j.wneu.2021.07.074 [doi]
AB  - BACKGROUND: Diabetes mellitus (DM) has been identified as a risk factor for 
      poorer outcomes following anterior cervical discectomy and fusion (ACDF). This 
      study aims to evaluate the impact DM has on achievement of MCID (minimum 
      clinically important difference) following ACDF. METHODS: A surgical database was 
      reviewed for patients who underwent primary, single-level ACDF procedures with 
      posterior instrumentation. Visual analog scales (VAS) Arm and Neck, Neck 
      Disability Index (NDI), and Patient-Reported Outcomes Measurement Information 
      System (PROMIS) and 12-item Short Form (SF-12) scores for physical function (PF) 
      were recorded. MCID achievement was calculated using pre-established values from 
      the literature. Intergroup differences in demographic, perioperative 
      characteristics, mean outcome scores and rates of MCID achievement were 
      calculated. RESULTS: There were 43 patients with diabetes and 320 patients 
      without diabetes. DM status was significantly associated with age, ethnicity, 
      hypertension, American Society of Anesthesiologists physical classification 
      score, Charlson Comorbidity Index, and insurance type (all P </= 0.041). 
      Postoperative length of stay was significantly greater for the DM group (P = 
      0.011). Mean VAS Arm and NDI differed at 6 months (P </= 0.049, both) and PROMIS-PF 
      differed from 6 weeks through 6 months (P </= 0.039, all). Patients without 
      diabetes significantly improved in all PROMs by 1 year postoperatively (P < 0.01, 
      all). Patients with diabetes significantly improved in VAS Neck and Arm, SF-12 
      physical component score, and PROMIS-PF by 1 year (all P </= 0.013) but NDI 
      significantly improved only at 12 weeks (P = 0.038). Intergroup differences for 
      MCID achievement were demonstrated at 6 months for NDI and SF-12 physical 
      component score (P </= 0.008). CONCLUSIONS: Although moderate intergroup 
      differences in MCID achievement were demonstrated, the results of this study 
      suggest that patients may realize similar benefits of ACDF surgery regardless of 
      DM status.
CI  - Copyright (c) 2021. Published by Elsevier Inc.
FAU - Lynch, Conor P
AU  - Lynch CP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Cha, Elliot D K
AU  - Cha EDK
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Patel, Madhav R
AU  - Patel MR
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Jacob, Kevin C
AU  - Jacob KC
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Mohan, Shruthi
AU  - Mohan S
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Geoghegan, Cara E
AU  - Geoghegan CE
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Jadczak, Caroline N
AU  - Jadczak CN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Singh, Kern
AU  - Singh K
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA. Electronic address: kern.singh@rushortho.com.
LA  - eng
PT  - Journal Article
DEP - 20210724
PL  - United States
TA  - World Neurosurg
JT  - World neurosurgery
JID - 101528275
SB  - IM
MH  - Diabetes Complications/*epidemiology
MH  - *Diskectomy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/*epidemiology
MH  - Retrospective Studies
MH  - *Spinal Fusion
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Anterior cervical discectomy and fusion
OT  - Diabetes mellitus
OT  - Minimum clinically important difference
OT  - Patient-reported outcomes
EDAT- 2021/07/27 06:00
MHDA- 2021/12/18 06:00
CRDT- 2021/07/26 20:14
PHST- 2021/05/17 00:00 [received]
PHST- 2021/07/15 00:00 [revised]
PHST- 2021/07/16 00:00 [accepted]
PHST- 2021/07/27 06:00 [pubmed]
PHST- 2021/12/18 06:00 [medline]
PHST- 2021/07/26 20:14 [entrez]
AID - S1878-8750(21)01081-0 [pii]
AID - 10.1016/j.wneu.2021.07.074 [doi]
PST - ppublish
SO  - World Neurosurg. 2021 Oct;154:e520-e528. doi: 10.1016/j.wneu.2021.07.074. Epub 
      2021 Jul 24.