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abstract

STRUCTURED ABSTRACT: Study Design. Retrospective review.Objective. To quantify the exact impact of NIDDM on operative complications and additional surgeries associated with Spinal Deformity Surgery.Summary of Background Data. There are many references supporting Diabetes Mellitus (DM) as one of the major risk factors for perioperative complications in spinal surgery. However, the results vary depending on the type of DM, suggesting Insulin Dependent DM (IDDM) causes more complications than Non-insulin dependent DM (NIDDM), which is far more prevalent in the adult spinal deformity population.Methods. Among 5119 adult deformity Patients (age>40), 23 NIDDM patients and 23 control (Group C) patients with a minimum 2-year follow-up were selected. Both groups were matched for age at surgery, gender, BMI, number of comorbidities, smoking history, current and prior fusion levels, EBL, and the amount of transfusion. Pre- and final SRS scores and ODI, number of perioperative complications and additional surgeries were compared. Within the NIDDM group, patients with (+) or without (-) complications were compared in terms of postoperative glucose control.Results. There were no significant differences in the number of major or minor complications, or additional surgeries between the 2 groups. There was no significant difference in postoperative glucose control with the NIDDM group (+) and (-). Group C reported significantly improved scores at final follow-up in all SRS domains and ODI. Group NIDDM reported improvement in all domains except for the mental health and pain domains. However, there were no significant differences between groups NIDDM and C in terms of SRS and ODI scores preop and postop.Conclusion. Contrary to traditional thinking, properly selected NIDDM was not a significant risk factor for perioperative complications or additional surgeries in adult spinal deformity patients.

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