{"id":86914,"date":"2024-06-13T04:00:10","date_gmt":"2024-06-13T08:00:10","guid":{"rendered":"https:\/\/news.utoledo.edu\/?p=86914"},"modified":"2024-06-18T08:49:33","modified_gmt":"2024-06-18T12:49:33","slug":"study-finds-diabetes-increases-the-risk-of-failure-in-spinal-fusion-procedures","status":"publish","type":"post","link":"https:\/\/news.utoledo.edu\/index.php\/06_13_2024\/study-finds-diabetes-increases-the-risk-of-failure-in-spinal-fusion-procedures","title":{"rendered":"Study Finds Diabetes Increases the Risk of Failure in Spinal Fusion Procedures"},"content":{"rendered":"

A new study from orthopaedic researchers at The University of Toledo has found lumbar spinal fusion procedures are far more likely to fail in individuals with diabetes.<\/p>\n

\u201cWe\u2019ve known for a long time that diabetic patients are at high risk of infection from any surgery, including spinal fusion,\u201d said Dr. Hossein Elgafy, a professor of orthopaedics in the College of Medicine and Life Sciences and chief of spine surgery at UTMC. \u201cMore recently, however, physicians have taken a closer look at the high rate of failure in those patients. A lot of times the bones simply aren\u2019t fusing.\u201d<\/p>\n

\"Dr.

Dr. Beata Lecka-Czernik, left, a professor in the Department of Orthopaedic Surgery, and Dr. Hossein Elgafy, chief of spine surgery at UTMC, recently collaborated on a study that found lumbar spinal fusion procedures are far more likely to fail in individuals with diabetes.<\/p><\/div>\n

The reason for that, UToledo researchers say, appears to be connected to how diabetes affects bone growth and healing.<\/p>\n

In a spinal fusion procedure, surgeons use a combination of screws, rods and bone grafts to join two or more vertebrae together. As the area heals the bones should fuse solidly together, restricting motion and relieving pain.<\/p>\n

Sometimes, however, the bones don\u2019t properly heal together. Surgeons call that a non-union complication, and it often leads to more pain and the need for additional, corrective surgery.<\/p>\n

While a risk for everyone, individuals with diabetes are particularly susceptible.<\/p>\n

In a study of more than 500 patients who underwent lumbar spinal fusion surgery at The University of Toledo Medical Center between 2009 and 2017, researchers found individuals with diabetes were nearly three times more likely than those without diabetes to experience non-union complications.<\/p>\n

Diabetic patients also were more than two times more likely to experience additional degeneration in adjacent segments of the spine after a spinal fusion procedure \u2014 another complication that usually requires extensive revision surgery.<\/p>\n

\u201cDiabetes is a metabolic disease, but it\u2019s also a bone disease,\u201d said Dr. Beata Lecka-Czernik, a diabetes researcher and professor in the Department of Orthopaedic Surgery and the study\u2019s corresponding author. \u201cIt has a very significant role in bone health, and that\u2019s what we\u2019re seeing here.\u201d<\/p>\n

In addition to reviewing patient data, researchers also analyzed tissue collected from both diabetic and non-diabetic patients who underwent revision surgeries. Those samples, which contained a mixture of connective tissue and developing bone, provided a unique insight into how the healing process in the two groups differed following spinal fusion surgery.<\/p>\n

\u201cThe bony samples from diabetic patients had much less developed structure, which means that even if the new bone formation happens, the quality of this new bone will be much worse,\u201d Lecka-Czernik said. \u201cThis is showing there is also an additional risk factor for spinal fusion complications, which is valuable for orthopaedic surgeons to know when treating patients with diabetes.\u201d<\/p>\n

The results of the study were published in the peer-reviewed journal JBMR Plus<\/a> and were recently presented at the Lumbar Spine Research Society\u2019s annual meeting in Chicago.<\/p>\n

Spinal fusion is generally a last-resort treatment after physical therapy and pain management strategies have failed to bring relief. Even so, it\u2019s a common surgery with hundreds of thousands of procedures performed every year in the United States.<\/p>\n

Diabetes is an independent risk factor for lower back disc degeneration \u2014 one of the most common reasons for spinal fusion surgery. With the rate of diabetes increasing in the United States, the number of spinal fusion procedures is likely to continue climbing as well.<\/p>\n

That makes it all the more important to identify and overcome the challenges unique to that patient population, Elgafy said.<\/p>\n

\u201cWe\u2019ve spent 20 years improving our techniques, our hardware and our technology,\u201d he said. \u201cNow the new wave in spine surgery is bone health. How do we improve bone health before we take people into surgery? It\u2019s an important question as we look to improve surgical outcomes and avoid patients having a second or third surgery. This study is an important first step.\u201d<\/p>\n

Elgafy said surgeons do have some tools at their disposal to reduce the risk of failure in diabetic patients, such as ensuring A1C and blood glucose are well-controlled prior to and after the procedure, and exploring biological scaffolds and other therapeutic agents to support new bone formation at the surgical site.<\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

UToledo orthopaedic researchers found individuals with diabetes were nearly three times more likely to have incomplete healing after spinal fusion surgery.<\/p>\n","protected":false},"author":849,"featured_media":86915,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[50,38,1,3,7,63],"tags":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/news.utoledo.edu\/index.php\/wp-json\/wp\/v2\/posts\/86914"}],"collection":[{"href":"https:\/\/news.utoledo.edu\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/news.utoledo.edu\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/news.utoledo.edu\/index.php\/wp-json\/wp\/v2\/users\/849"}],"replies":[{"embeddable":true,"href":"https:\/\/news.utoledo.edu\/index.php\/wp-json\/wp\/v2\/comments?post=86914"}],"version-history":[{"count":1,"href":"https:\/\/news.utoledo.edu\/index.php\/wp-json\/wp\/v2\/posts\/86914\/revisions"}],"predecessor-version":[{"id":86916,"href":"https:\/\/news.utoledo.edu\/index.php\/wp-json\/wp\/v2\/posts\/86914\/revisions\/86916"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/news.utoledo.edu\/index.php\/wp-json\/wp\/v2\/media\/86915"}],"wp:attachment":[{"href":"https:\/\/news.utoledo.edu\/index.php\/wp-json\/wp\/v2\/media?parent=86914"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news.utoledo.edu\/index.php\/wp-json\/wp\/v2\/categories?post=86914"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news.utoledo.edu\/index.php\/wp-json\/wp\/v2\/tags?post=86914"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}