Diabetes may hamper benefits of spine surgery for patients with herniated discs

Sep 12 2011
While spine surgery can be a useful treatment for individuals with herniated discs, spinal stenosis or degenerative spondylolisthesis, new research suggests that those who have diabetes may not reap its full rewards.

In the early 2000s, the National Institute of Arthritis and Muskuloskeletal and Skin Diseases (NIAMS), a branch of the National Institutes of Health, helped set up a multicenter series of medical trials known as the Spine Patient Outcomes Research Trial (SPORT). The aim of the program was to provide better guidance for doctors treating spinal conditions.

One trial assessed the results of diabetic patients undergoing spine surgery against those of non-diabetic patients having surgery for the same conditions, which included intervertebral disc herniation, spinal stenosis and degenerative spondylolisthesis.

The spinal cord is protected by the vertebrae, a series of bones with cushions of gel in between them known as discs. Misalignment or degeneration of any of these structures can cause intense pain in the back or other parts of the body. Intervertebral disc herniation occurs when one of the discs in the spine ruptures, while spinal stenosis happens when parts of the spinal canal narrow and put pressure on the spinal cord, according to NIAMS. Degenerative spondylolisthesis, a condition when one vertebra slips out of its proper alignment, can lead to spinal stenosis.

All of these conditions may be treated through spine surgery, such as removal of injured discs or adjusting the structures that are hurting the spinal cord, or nonsurgical treatments, such as chiropractic manipulation or acupuncture. A new study says that patients who are diabetic may have to weigh the costs and benefits of surgery more carefully.

The SPORT trial compared the outcomes of 199 spine surgery patients with diabetes against subjects without the blood sugar disorder. Results showed that not only did diabetics not improve as significantly as the controls, but those who had surgery to correct intervertebral disc herniations did not fare any better than individuals who had nonsurgical treatment. Diabetics also tended to experience more complications from surgery.

When analyzing these results, it's important to consider that research subjects with diabetes tended to be older and more obese, NIAMS said.