Lumbar spine fusions more likely to fail in patients with diabetes: Study

Spine

Lumbar spinal fusion procedures are more likely to fail in patients with diabetes, according to a new study from the University of Toledo (Ohio). 

Researchers believe that the failure rate could be linked to how diabetes impacts bone growth and healing, according to a July 9 news release from the university. 

Following the procedure, some patients' bones do not fuse solidly together, causing a non-union complication that often leads to more pain and the need for additional, corrective surgery.

Individuals with diabetes are particularly susceptible to nonunion complications, according to the release. 

The study of 500 patients who underwent lumbar spinal fusion surgery at the University of Toledo Medical Center between 2009 and 2017 determined that individuals with diabetes were nearly three times more likely than those without diabetes to experience nonunion complications.

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.

An earlier study also linked the weight loss and diabetes medication semaglutide to a significantly greater risk for repeat operations in patients with diabetes who require lumbar surgery. 

The risk of an additional procedure was higher among patients who took semaglutide over long periods of time.

Historically, surgeons have already had to proceed with caution when it comes to treating obese or diabetic patients requiring spinal procedures. 

"Obese patients bleed more. They have more wound healing issues. More infections. More general complications. They have more reoperations. This occurs even in the most skilled hands. I've been a spine surgeon for 23 years and done more than 10,000 cases, but BMI >40 patients have more complications that I cannot control. It's operator independent," Lali Sekhon, MD, a neuro and spine surgeon at Reno (Nev.) Orthopedic Center, told Becker's

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