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논문 기본 정보

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저자정보
Shinji Tanishima (Orthopedic Surgery Faculty of Medicine Tottori University Tottori Japan) Tokumitsu Mihara (Orthopedic Surgery Faculty of Medicine Tottori University Tottori Japan) Atsushi Tanida (Orthopedic Surgery Faculty of Medicine Tottori University Tottori Japan) Chikako Takeda (Orthopedic Surgery Faculty of Medicine Tottori University Tottori Japan) Masaaki Murata (Orthopaedic Surgery Tottori Central Prefectural Hospital Tottori Japan) Toshiaki Takahashi (Orthopedic Surgery Tottori Red Cross Hospital Tottori Japan) Koji Yamane (Orthopedic Surgery Tottori Red Cross Hospital Tottori Japan) Tsugutake Morishita (Orthopedic Surgery Tottori Municipal Hospital Tottori Japan) Yasuo Morio (Orthopaedic Surgery Misasa Onsen Hospital Tottori Japan) Hiroyuki Ishii (Orthopaedic Surgery Misasa Onsen Hospital Tottori Japan) Satoru Fukata (Orthopaedic Surgery Misasa Onsen Hospital Tottori Japan) Yoshiro Nanjo (Orthopedic Surgery Sanin Rosai Hospital Yonago Japan) Yuki Hamamoto (Orthopaedic Surgery Matsue City Hospital Matsue Japan) Toshiyuki Dokai (Orthopedic Surgery Masuda Redcross Hospital Tottori Japan) Hideki Nagashima (Orthopedic Surgery Faculty of Medicine Tottori University)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.13 No.3
발행연도
2019.1
수록면
468 - 477 (10page)

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Study Design: Multicenter, prospective study. Purpose: To investigate the effects of diabetes mellitus (DM) on surgical outcomes in patients with cervical myelopathy. Overview of Literature: To date, few studies have investigated the influence of postoperative blood glucose or glycated hemoglobin (HbA1c) levels on surgical outcomes. Methods: The participants were patients who underwent surgery for the treatment of cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. The 61 cases were evaluated preoperatively and 1 year postoperatively using the Japanese Orthopaedic Association (JOA) scores and the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). The study variables included fasting blood glucose and HbA1c levels measured preoperatively and at 1 week, 4 weeks, and 1 year postoperatively; the F-wave conduction velocity, latency, rate of occurrence, and M-wave latency in the ulnar and tibial nerves were measured preoperatively and at 1 year postoperatively. The patients were divided into a group without diabetes (N group, 42 patients) and a group with diabetes (DM group, 19 patients). We then assessed the associations between the surgical outcomes and each of the study variables. Results: JOA scores significantly improved in both groups; however, no significant between-group differences were found. There was no significant improvement in the JOACMEQ scores, which assessed cervical function, upper and lower limb function, and bladder function in both groups. We then subdivided the DM group into those with a good control of HbA1c after 1 year (DMG group, 12 patients) and those with HbA1c deterioration after 1 year (DMB group, seven patients), prior to comparing the surgical outcomes. The JOACMEQ scores for upper and lower limb function significantly improved in the DMG group (p<0.01). Compared with the DMB group, there were no significant increases in upper or lower limb function scores in the DMG group. Conclusions: Poor glycemic control might prevent postoperative functional recovery of the spinal cord.
#Neck #Spinal cord compression #Diabetes mellitus #Treatment outcome #Electromyography

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참고문헌 (30)

참고문헌 신청
Lees F / 1963 / Natural history and prognosis of cervical spondylosis / Br Med J 2:1607~1610 google schola Hayashi H / 1988 / Cervical spondylotic myelopathy in the aged patient : a radiographic evaluation of the aging changes in the cervical spine and etiologic factors of myelopathy / Spine(Phila Pa 1976) 13:618~625 google schola Machino M / 2014 / Impact of diabetes on the outcomes of cervical laminoplasty : a prospective cohort study of more than 500 patients with cervical spondylotic myelopathy / Spine(Phila Pa 1976) 39:220~227 google schola Kawaguchi Y / 2000 / Surgical outcome of cervical expansive laminoplasty in patients with diabetes mellitus / Spine(Phila Pa 1976) 25:551~555 google schola Dokai T / 2012 / Surgical outcomes and prognostic factors of cervical spondylotic myelopathy in diabetic patients / Arch Orthop Trauma Surg 132:577~582 google schola

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