The Journal of Bone and Joint Surgery, Vol 75, Issue 12 1823-1829, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
The results of operations on the lumbar spine in patients who have diabetes mellitus
JM Simpson, CP Silveri, RA Balderston, FA Simeone and HS An
Department of Orthopaedic Surgery, Rothman Institute, Pennsylvania Hospital, Philadelphia 19107.
The results for sixty-two patients who had had a diagnosis of diabetes
mellitus and lumbar disc disease or spinal stenosis and had been managed
with a posterior decompressive procedure were compared, in a retrospective
study, with those for sixty-two age and sex-matched non-diabetic (control)
patients who had had similar operative procedures. Forty-four of the
sixty-two diabetic patients and fifty-five of the non-diabetic patients
were available for long-term follow-up (mean, five and seven years,
respectively). Among the diabetic patients, there were high rates of
postoperative infection and prolonged hospitalization compared with the
rates for the control group. The long-term result was excellent or good for
seventeen (39 per cent) of the forty-four patients who had diabetes
mellitus and for fifty-two (95 per cent) of the fifty-five non-diabetic
patients. The poor results in the diabetic patients may have been related
to coexisting diabetic neuropathy, to the associated microvascular disease
that affects the spinal nerve roots in diabetic patients, or to the failure
of the nerve roots of these patients to recover after decompressive
procedures.