Lumbar spinal stenosis and diabetes. Outcome of surgical decompression

Cinotti, Gianluca; Postacchini, Franco; Jn, Weinstein

doi:10.1302/0301-620x.76b2.8113279

Cited by 51 publications

(38 citation statements)

References 0 publications

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“…The results of lumbar spine decompression for spinal stenosis in 25 diabetic patients and 25 non-diabetic patients were compared after an average follow up of 3.4 years. This study did not identify any difference in outcomes, and the authors proposed that patients with DM could expect to have similar improvement in symptoms as non-diabetic patients [63] .…”

Section: Lumbar Surgerymentioning

confidence: 63%

Diabetes and its negative impact on outcomes in orthopaedic surgery

Wukich

2015

WJO

115

103

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An estimated 285 million adults (aged 20-79 years) worldwide were diagnosed to have diabetes mellitus (DM) in 2010, and this number is projected to grow to 439 million adults by the year 2030. Orthopaedic surgeons, regardless of their subspecialty interest, will encounter patients with DM during their career since this epidemic involves both developed and emerging countries. Diabetes results in complications affecting multiple organ systems, potentially resulting in adverse outcomes after orthopaedic surgery. The purpose of this review is to discuss the pathophysiology of DM and its potential for impacting orthopaedic surgery patients. Diabetes adversely affects the outcome of all orthopaedic surgery subspecialties including foot and ankle, upper extremity, adult reconstructive, pediatrics, spine surgery and sports medicine. Poorly controlled diabetes negatively impacts bone, soft tissue, ligament and tendon healing. It is the complications of diabetes such as neuropathy, peripheral artery disease, and end stage renal disease which contributes to adverse outcomes. Well controlled diabetic patients without comorbidities have similar outcomes to patients without diabetes. Orthopaedic surgeons should utilize consultants who will assist in inpatient glycemic management as well as optimizing long term glycemic control.

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Section: Lumbar Surgerymentioning

confidence: 63%

Diabetes and its negative impact on outcomes in orthopaedic surgery

Wukich

2015

WJO

115

103

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“…A previous study [5] comprising 25 diabetic and 25 nondiabetic patients concluded that the outcome of surgery was similarly successful in the two groups. Another study [17] showed poor results in the diabetic patients that may have been related to coexisting diabetic neuropathy.…”

mentioning

confidence: 79%

“…One study [5] reported positive results (excellent and good) in 42% of DG patients and 91% of CG patients, while another study [17] could not show a statistically significant difference in the surgical outcome between DG and CG patients (72 and 80% of positive results, respectively). Satisfaction or dissatisfaction rates were somewhat more prevalent among female patients within each group, but otherwise there were no practical differences between the DG and CG.…”

Section: Complicationmentioning

confidence: 96%

Outcomes of decompression surgery for lumbar spinal stenosis in elderly diabetic patients

Arinzon¹,

Adunsky

Fidelman³

et al. 2004

European Spine Journal

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“…Diyabetik amiyotrofi'nin klinik semptom ve bulguları disk herniasyonu ve/veya spinal stenoz ile sıklıkla karışabilmektedir [4,5,13]. Her ikisinde de tek taraflı güç kaybı, uyluğun ön yüzüne yayılan ağrı ve uyuşma şikayeti olabilir.…”

Section: Discussionunclassified

“…Lomber disk hernili (LDH) hastalarda da benzer şe-kilde tek taraflı veya her iki alt ekstremitede ağrı ve güçsüzlük gelişebilir. Diyabetli hastalar tek taraflı alt ekstremite ağrı ve güçsüzlüğü tariflediğinde DA ve LDH'nın ayırıcı tanısı zor olabilir [4,5,6]. Bu iki hastalığın ayırıcı tanısındaki zorluk sebebiyle hastalara gereksiz LDH cerrahisi uygulanabilir [4].…”

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Weakness of unilateral lower limb’s proximal muscle; diabetic amyotrophy coexisting with lumbar discopathy: Case report and review of the literature

Kurt¹

2014

Dicle Med J

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Diabetic amyotrophy is a relatively infrequent complication of diabetes mellitus is most often characterized by weakness of unilateral lower limb and pain. Clinical differentiation from lumbar disc herniation may be difficult. ıt was hereby presented; 64 year old male patient who has 15 year old history of diabetes mellitus and lumbar discopathy previously diagnosed. He had weakness of unilateral lower limb and pain. Patient was admitted right thigh pain and weakness of proximal lower limb muscle. The physical examination, magnetic resonance imaging and electromyographic examination of the patient was consistent with the diagnosis of diabetic amyotrophy. When diabetic amyotrophy and lumbar disc herniaton coexist as a pain source, which disease responsible from pain should be detected well and treatments should be arrenged according to responsible disease. Thus, unnecessary surgeries can be avoided.Key words: Diabetes mellitus, lumbar disc herniation, diabetic amyotrophy ÖZET Diyabetin nadir bir komplikasyonu olan diyabetik amiyotrofi genellikle tek taraflı alt ekstremitede proksimal kas güçsüzlüğü ve ağrı ile seyreder. Klinik olarak lomber diskopatiden ayırımı zor olabilir. Bu olguda daha önce lomber diskopati tanısı konmuş ve 15 yıllık diyabetes mellitusu olan erkek hasta sunulmuştur. Hasta sağ uyluk bölgesinde ağrı, sağ alt ekstemite kas güçsüzlüğü şika-yeti polikliniğe başvurdu. Hastaya fizik muayene, manyetik rezonans görüntüleme ve elektrofizyolojik çalışmalar sonunda Diabetik amiyotrofi tanısı konulmuştur. Özellikle ağrı nedeni olarak lomber diskopti ve diyabetik amiyotrofi birlikteliğinde hastanın şikayetinin hangi hastalıktan kaynaklandığının iyi belirlenmesi ve tedavinin ona göre düzenlenmesi sağlanmalıdır. Böylece gereksiz cerrahi müdahaleden kaçınılmış olur.Anahtar kelimeler: Diyabet, lomber diskopati, diyabetik amiyotrofi GİRİŞ Diyabetik polinöropati (DPNP) diyabetes mellitusun (DM) sık komplikasyonlarından biridir. Kan glukoz düzeyinin yüksekliği ve hastalık süresi ile ilişkilidir [1,2]. Diyabetik amiyotrofi (DA), DP-NP'nin nadir bir formudur. Alt ekstremite proksimalinde akut veya subakut gelişen genellikle asimetrik güçsüzlük ve atrofi ile karakterizedir [3]. Lomber disk hernili (LDH) hastalarda da benzer şe-kilde tek taraflı veya her iki alt ekstremitede ağrı ve güçsüzlük gelişebilir. Diyabetli hastalar tek taraflı alt ekstremite ağrı ve güçsüzlüğü tariflediğinde DA ve LDH'nın ayırıcı tanısı zor olabilir [4,5,6]. Bu iki hastalığın ayırıcı tanısındaki zorluk sebebiyle hastalara gereksiz LDH cerrahisi uygulanabilir [4].Bu olguda lomber diskopati ve DA birlikteliği olan bir hastanın ayırıcı tanısı ve tedavi yaklaşımla-rı tartışılmıştır. OLGUAltmışdört yaşında 15 yıldır diyabetes mellitusun tanısı olan erkek hasta (A.Ö) 5 ay önce sağ bacağa yayılan bel ağrısı ve ayaklarda uyuşma şikayeti ile polikliniğimize başvurdu. Hastanın muayenesinde ,bel eklem hareket açıklığı; fleksiyonu sonlara doğ-ru ağrılı ve kısıtlı, diğer yönlere ağrılı ama açıktı.

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Lumbar spinal stenosis and diabetes. Outcome of surgical decompression

Cited by 51 publications

References 0 publications

Diabetes and its negative impact on outcomes in orthopaedic surgery

Diabetes and its negative impact on outcomes in orthopaedic surgery

Outcomes of decompression surgery for lumbar spinal stenosis in elderly diabetic patients

Weakness of unilateral lower limb’s proximal muscle; diabetic amyotrophy coexisting with lumbar discopathy: Case report and review of the literature

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