Assessment of the Factors Affecting the Outcome of Surgical Treatment of Discopathy and/or Spinal Canal Stenosis in Patients with and without Diabetes Mellitus

Introduction & The aim of this study is the assessment of the factors effective in the outcome of surgical treatment of discopathy and or spinal canal stenosis among two groups of patients with and without diabetes mellitus (DM) at Sina Hospital during 2006-2009. We conducted a prospective cohort on all the patients with discopathy and/or spinal canal stenosis, who underwent surgical treatment at Sina hospital, Tehran University of Medical Sciences during during 2007-2009. The patients were divided into 2 groups according to being diabetic or nondiabetic. All the varients were included in the validated data sheet. The operations were performed according to the clinical findings, images and the attending surgeons’ preference. They were followed up for 1 and 6 months and annually thereafter. To measure the outcome a modification of the Owestry low back pain disability questionnaire and basic activity daily living (BADL) was used. Data were analyzed using SPSS version 13. There were 152 male and 137 female patients with the age range between 15 to 80 years, mean=52±12 years. Patients with DM reported signs and symptoms of illness for a longer period of time compared to nondiabetic patients. The mean value of the Owestry disability score was 36.1 for diabetic and 20.0 for nondiabetic cases. Walking distance, incontinency and BADL did not show any statistical differences between two groups preoperatively. However, they indicated marked improvement in both groups. Pain relief was not reported by two diabetic patients and 18 non-diabetics (P=0.111). One case of death was reported among diabetic group and two cases of death occurred among non-diabetics. Four cases of reoperation were registered during the follow up period (one diabetic and 3 non-diabetic patients). Due to the prevalence of the combination of disc herniation and lumbar spinal canal stenosis in the population, it may be impossible to distinguish between the two affections in a specific manner, but It can be concluded that 1) spinal canal stenosis appears in more advanced stages among diabetic patients and 2) long term outcome of surgical treatment is not as good for diabetic patients as the case of nondiabetic patients 3) the difference is not statistically significant between the two groups.