PMID- 34463136
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230826
IS  - 2192-5682 (Print)
IS  - 2192-5690 (Electronic)
IS  - 2192-5682 (Linking)
VI  - 13
IP  - 6
DP  - 2023 Jul
TI  - Minimally Invasive vs. Open Surgery for Lumbar Spinal Stenosis in Patients with 
      Diabetes - A Canadian Spine Outcomes and Research Network Study.
PG  - 1602-1611
LID - 10.1177/21925682211042576 [doi]
AB  - STUDY DESIGN: Retrospective cohort. OBJECTIVES: To compare outcomes of minimally 
      invasive surgery (MIS) vs open surgery (OPEN) for lumbar spinal stenosis (LSS) in 
      patients with diabetes. METHODS: Patients with diabetes who underwent spinal 
      decompression alone or with fusion for LSS within the Canadian Spine Outcomes and 
      Research Network (CSORN) database were included. MIS vs OPEN outcomes were 
      compared for 2 cohorts: (1) patients with diabetes who underwent decompression 
      alone (N = 116; MIS n = 58 and OPEN n = 58), (2) patients with diabetes who 
      underwent decompression with fusion (N = 108; MIS n = 54 and OPEN n = 54). 
      Modified Oswestry Disability Index (mODI) and back and leg pain were compared at 
      baseline, 6-18 weeks, and 1-year post-operation. The number of patients meeting 
      minimum clinically important difference (MCID) or minimum pain/disability at 
      1-year was compared. RESULTS: MIS approaches had less blood loss (decompression 
      alone difference 100 mL, P = .002; with fusion difference 244 mL, P < .001) and 
      shorter length of stay (LOS) (decompression alone difference 1.2 days, P = .008; 
      with fusion difference 1.2 days, P = .026). MIS compared to OPEN decompression 
      with fusion had less patients experiencing adverse events (AEs) (difference 13 
      patients, P = .007). The MIS decompression with fusion group had lower 1-year 
      mODI (difference 14.5, 95% CI [7.5, 21.0], P < .001) and back pain (difference 
      1.6, 95% CI [.6, 2.7], P = .002) compared to OPEN. More patients in the MIS 
      decompression with fusion group exceeded MCID at 1-year for mODI (MIS 75.9% vs 
      OPEN 53.7%, P = .028) and back pain (MIS 85.2% vs OPEN 70.4%, P = .017). 
      CONCLUSIONS: MIS approaches were associated with more favorable outcomes for 
      patients with diabetes undergoing decompression with fusion for LSS.
FAU - Hathi, Kalpesh
AU  - Hathi K
AUID- ORCID: 0000-0003-0362-5623
AD  - Dalhousie Medicine New Brunswick, Saint John, NB, Canada. RINGGOLD: 471849
FAU - Bigney, Erin
AU  - Bigney E
AD  - Canada East Spine Centre, Saint John, NB, Canada.
AD  - Horizon Health Network, Saint John, NB, Canada. RINGGOLD: 10068
FAU - Richardson, Eden
AU  - Richardson E
AD  - Canada East Spine Centre, Saint John, NB, Canada.
AD  - Horizon Health Network, Saint John, NB, Canada. RINGGOLD: 10068
AD  - Canadian Spine Outcomes and Research Network, Markham, ON, Canada.
FAU - Alugo, Tolu
AU  - Alugo T
AD  - Dalhousie Medicine New Brunswick, Saint John, NB, Canada. RINGGOLD: 471849
AD  - Saint John Regional Hospital, Saint John, NB, Canada. RINGGOLD: 72881
FAU - El-Mughayyar, Dana
AU  - El-Mughayyar D
AUID- ORCID: 0000-0003-0074-1194
AD  - Canada East Spine Centre, Saint John, NB, Canada.
FAU - Vandewint, Amanda
AU  - Vandewint A
AD  - Canada East Spine Centre, Saint John, NB, Canada.
FAU - Manson, Neil
AU  - Manson N
AD  - Dalhousie Medicine New Brunswick, Saint John, NB, Canada. RINGGOLD: 471849
AD  - Canada East Spine Centre, Saint John, NB, Canada.
AD  - Saint John Orthopaedics, Saint John, NB, Canada.
FAU - Abraham, Edward
AU  - Abraham E
AD  - Dalhousie Medicine New Brunswick, Saint John, NB, Canada. RINGGOLD: 471849
AD  - Canada East Spine Centre, Saint John, NB, Canada.
AD  - Saint John Orthopaedics, Saint John, NB, Canada.
FAU - Small, Chris
AU  - Small C
AD  - Dalhousie Medicine New Brunswick, Saint John, NB, Canada. RINGGOLD: 471849
AD  - Canada East Spine Centre, Saint John, NB, Canada.
AD  - Saint John Orthopaedics, Saint John, NB, Canada.
FAU - Thomas, Kenneth
AU  - Thomas K
AD  - University of Calgary, Calgary, AB, Canada. RINGGOLD: 70401
FAU - Fisher, Charles G
AU  - Fisher CG
AD  - University of British Columbia, Vancouver, BC, Canada. RINGGOLD: 8166
FAU - Rampersaud, Y Raja
AU  - Rampersaud YR
AD  - University of Toronto, Toronto, ON, Canada. RINGGOLD: 12366
FAU - Hall, Hamilton
AU  - Hall H
AD  - University of Toronto, Toronto, ON, Canada. RINGGOLD: 12366
FAU - McIntosh, Greg
AU  - McIntosh G
AUID- ORCID: 0000-0002-0268-6523
AD  - Canadian Spine Outcomes and Research Network, Markham, ON, Canada.
FAU - Johnson, Michael G
AU  - Johnson MG
AD  - University of Manitoba, Winnipeg, MB, Canada. RINGGOLD: 423134
FAU - Bailey, Christopher S
AU  - Bailey CS
AD  - Western University, London, ON, Canada. RINGGOLD: 10033
FAU - Weber, Michael H
AU  - Weber MH
AD  - McGill University, Montreal, QC, Canada. RINGGOLD: 12367
FAU - Paquet, Jerome
AU  - Paquet J
AD  - McGill University, Montreal, QC, Canada. RINGGOLD: 12367
FAU - Kingwell, Stephen
AU  - Kingwell S
AD  - The Ottawa Hospital, Ottawa, ON, Canada. RINGGOLD: 27337
FAU - Nataraj, Andrew
AU  - Nataraj A
AD  - University of Alberta, Edmonton, AB, Canada. RINGGOLD: 3158
FAU - Finkelstein, Joel
AU  - Finkelstein J
AD  - Sunnybrook Health Sciences Centre, Toronto, ON, Canada. RINGGOLD: 71545
FAU - Kelly, Adrienne
AU  - Kelly A
AUID- ORCID: 0000-0002-7536-8884
AD  - Sault Area Hospital, Sault St. Marie, ON, Canada. RINGGOLD: 10066
FAU - Attabib, Najmedden
AU  - Attabib N
AD  - Canada East Spine Centre, Saint John, NB, Canada.
AD  - Saint John Regional Hospital, Saint John, NB, Canada. RINGGOLD: 72881
LA  - eng
PT  - Journal Article
DEP - 20210831
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
PMC - PMC10448101
OTO - NOTNLM
OT  - decompression
OT  - diabetes
OT  - low back pain
OT  - patient-reported outcome measures
OT  - spinal fusion
OT  - spinal stenosis
COIS- The author(s) declared no potential conflicts of interest with respect to the 
      research, authorship, and/or publication of this article
EDAT- 2021/09/01 06:00
MHDA- 2021/09/01 06:01
PMCR- 2021/08/31
CRDT- 2021/08/31 08:44
PHST- 2021/09/01 06:01 [medline]
PHST- 2021/09/01 06:00 [pubmed]
PHST- 2021/08/31 08:44 [entrez]
PHST- 2021/08/31 00:00 [pmc-release]
AID - 10.1177_21925682211042576 [pii]
AID - 10.1177/21925682211042576 [doi]
PST - ppublish
SO  - Global Spine J. 2023 Jul;13(6):1602-1611. doi: 10.1177/21925682211042576. Epub 
      2021 Aug 31.