Impact of Hypertension in Diabetes on Surgical Outcomes After Cervical Laminoplasty - a Retrospective, Multi-institutional Study of 1002 Patients

Overview

Journal Eur Spine J

Date 2025 Feb 5

PMID 39909892

Authors

Yusuke Tomomatsu

Eiji Takasawa

Yoichi Iizuka

Tokue Mieda

Hirokazu Inoue

Atsushi Kimura

Katsushi Takeshita

Hiroyuki Sonoda

Kenta Takakura

Yasunori Sorimachi

Tsuyoshi Ara

Kosuke Shida

Takashi Nakajima

Satoshi Tsutsumi

Hidekazu Arai

Hiroshi Moridaira

Hiroshi Taneichi

Toru Funayama

Hiroshi Noguchi

Kousei Miura

Ryoichi Kobayashi

Haku Iizuka

Masaaki Chazono

Hirotaka Chikuda

Affiliations

Soon will be listed here.

Abstract

Purpose: This study aimed to elucidate the association between comorbid hypertension (HT) and diabetes mellitus (DM) (HT in DM) and clinical outcomes after cervical laminoplasty.

Methods: This retrospective multi-institutional study enrolled patients who underwent laminoplasty between 2008 and 2017. The primary outcome was the recovery rate of JOA score. The secondary outcome was in-hospital all-cause postoperative complications.

Results: This study included 1002 patients (mean age, 66 years; 30% women) who were divided into 4 groups based on the presence of medically-treated HT and/or DM. The overall incidence of DM was 17%, and the prevalence of HT was 47% in diabetic patients. Patients with HT in DM showed similar preoperative JOA scores compared to those without both HT and DM. However, patients with HT in DM showed poorer postoperative JOA scores and worse JOA-RR (non-HT/DM, 48%; DM, 43%; HT, 37%; HT in DM, 28%; p < 0.05). Patients with HT in DM tended to have a higher risk of postoperative complications (2.5%, 5.4%, 3.0%, and 7.4%; p = 0.09), especially C5 palsy (0.8%, 3.0%, 1.7%, and 4.9%; p = 0.04). After adjusting confounders, the presence of HT in DM was an independent risk factor for failure to achieve the JOA-RR MCID (JOA-RR < 42%) (OR = 3.6).

Conclusions: Approximately half of patients with DM had HT. HT in DM was closely associated with unfavorable surgical outcomes, including an increased incidence of in-hospital postoperative complications and an elevated risk of C5 palsy. In contrast, patients with DM alone demonstrated relatively favorable outcomes.

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