The Impact of Diabetes Mellitus on Patients Undergoing Cervical Spondylotic Myelopathy: A Meta-Analysis
The Impact of Diabetes Mellitus on Patients Undergoing Cervical Spondylotic Myelopathy: A Meta-Analysis
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DOI：
10.1159/000453547
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发表时间：
2017-01-01
影响因子：
2.4
通讯作者：
Feng, Shi-qing
中科院分区：
文献类型：
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作者：
Liu, Yang;Ban, De-xiang;Feng, Shi-qing
目的：我们对符合条件的研究进行了荟萃分析，以比较患有脊髓型颈椎病（CSM）的糖尿病患者和非糖尿病患者的手术结局。方法：对PubMed、Embase和Web of Science（截至2016年2月10日）进行了系统性文献检索。符合条件的研究是比较糖尿病患者和非糖尿病患者颈椎手术结局的病例对照或队列研究。计算加权平均差、风险比和95%CI，并采用科克伦Q卡方检验和I-2统计量评估异质性。结果：本荟萃分析纳入了6项研究，共38，680例患者。合并估计值显示，糖尿病患者手术前后的日本骨科协会（乔亚）评分变化和恢复率显著低于非糖尿病患者。此外，糖尿病患者手术伤口、硬膜外/伤口血肿、慢性肺部疾病和心脏并发症的风险显著增加。其他术后并发症，包括脑脊液漏和C5神经根病，在两组之间没有显著差异。结论：糖尿病降低了CSM患者的乔亚评分变化和恢复率，并增加了术后并发症的风险。颈椎手术前控制糖尿病可能会导致更好的结果。(C)2016 S. Karger AG，巴塞尔
Aims: We conducted a meta-analysis of eligible studies to compare the surgical outcomes between diabetic patients and non-diabetic patients who have undergone cervical spondylotic myelopathy (CSM). Methods: A systematic literature search of PubMed, Embase, and Web of Science (up to February 10, 2016) was conducted. Eligible studies were case control or cohort studies that compared the outcomes of cervical surgery between diabetic patients and non-diabetic patients. Weighted mean differences, risk ratios, and 95% Cls were calculated and heterogeneity was assessed with Cochrane Q chi-square test and I-2 statistic. Results: Six studies with a total of 38,680 patients were included in this meta-analysis. Pooled estimates showed that diabetic patients had significantly lower Japanese Orthopaedic Association (JOA) score change between pre- and post operation, and recovery rate than patients without diabetes. Moreover, diabetic patients had significantly increased risk of operative wound, epidural/wound hematoma, chronic lung disease, and cardiac complication. Other postoperative complications, including cerebrospinal fluid leakage and C5 radiculopathy, were not significantly different between the 2 groups. Conclusion: Diabetes mellitus decreased the JOA score change and recovery rate, as well as increased the risk of postoperative complications in patients undergoing CSM. Controlling diabetes mellitus before cervical spine surgery may lead to better outcomes. (C) 2016 S. Karger AG, Basel