The Impact Of Diabetes Upon Quality Of Life Outcomes After Anterior Cervical Corpectomy Decompression And Fusion

Objectives:Patients with comorbidities may not be able to achieve optimal quality of life improvement after anterior cervical corpectomy decompression and fusion(ACCF).Previous studies have suggested that diabetes has an adverse effect on postoperative quality of life in patients;however,these studies did not use univariate prognostic analysis,the multivariate cox proportional hazards analysis and minimal important clinical differences techniques.BACKGROUND: Patients with comorbid conditions may not be able to achieve optimal quality of life improvement after Anterior cervical corpectomy decompression and fusion(ACCF).Previous studies have suggested that diabetes has an adverse effect on postoperative quality of life in patients;however,these studies did not use single,multivariate statistical techniques and minimal important clinical differences techniques.The purpose of this study was to evaluate the effect of preoperative diabetes on quality of life after Anterior cervical corpectomy decompression and fusion.Methods:Single center retrospective cohort study in a top three hospital.Quality of life data from Fujian Medical University Affiliated Union Hospital Orthopedic Database.Patients undergoing Anterior cervical corpectomy decompression and fusion for follopw-up at least 9 months between 2013 and 2016 were enrolled.Data were collected in the form of patient self-reported health status.The main final study index was the changes of ODI,NDI,JOA and VAS scores at preoperative and postoperative follow-up.Secondary indicators for hospitalization,hospitalization costs,preoperative and postoperative hemoglobin difference and operation time.Independent sample t-test was used to assess the normalization of postoperative quality of life in patients with diabetes by single and multivariate Logistic regression.Results:61 patients met the inclusion criteria.The results of ODI,NDI,VAS and JOA in non-diabetic patients were significantly improved(P <0.01),but no significant improvement was found in diabetic patients.Multivariable regression analysis showed that diabetes and BMI(P <0.05)were independent predictors of postoperative improvement of NDI.Conclusion:Preoperative complications may influence the quality of life of patients undergoing anterior cervical corpectomy decompression and fusion.This study found that diabetes is an independent predictor of quality of life in patients with anterior cervical spine subtotal decompression and fusion surgery,compared with non-diabetic patients,poor quality of life in diabetic patients after treatment.