[ NEWS - SPINE ]
98,000 Patient Study Links Diabetes to Spinal Stenosis
According to the Centers for Disease Control and
Prevention , 38.4 million people in the U . S . have diabetes , 97.6 million people 18 or older have prediabetes and 27.2 million people 65 and older have prediabetes . As our population stands at roughly 336,377,915 people , those in the above categories represent nearly half of the country .
To what extent is diabetes a risk factor for lumbar spinal stenosis ? An international team of researchers designed a massive study to quantify the connection between diabetes and lumbar spinal stenosis . Their work , “ Diabetes Mellitus and Poor Glycemic Control Are Associated With a Higher Risk of Lumbar Spinal Stenosis : An Analysis of a Large Nationwide Database ,” was published in the May 1 , 2024 edition of Spine .
Co-author Assaf Kadar , M . D . an orthopedic surgeon at the Rabin Medical Center , Beilinson Hospital , Petah Tikva , Israel , told OTW , “ Dr . Shai Shemesh , who is the lead author , postulated that the ligamentum flavum , the culprit of spinal stenosis , is in fact an overlooked ‘ target organ ’ for diabetes . The effect of diabetes on other target organs ( nerves , retina , kidney and more ) have been extensively studied , but there is scarce literature about spinal stenosis .” effect of high glucose levels on tissues ) effects the ligamentum flavum in a dose dependent manner .”
“ The study will help surgeons and physicians educate their patients on the deleterious effect of poor diabetes control on spinal stenosis . All physicians like to quote that ‘ Prevention is better than cure .’ We feel that with our findings , clinicians have a powerful prevention tool that can be specifically applied to diabetic patients with early spinal stenosis .”
Going forward , Dr . Kadar told OTW , “ We need to have basic science studies defining the mechanism of the effect of high glucose levels on the ligamentum flavum . In addition , we need large-scale prospective clinical trials looking at the various diabetes treatment options and its effect on spinal stenosis .” — EH
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In total , 49,576 patients diagnosed with lumbar spinal stenosis were matched with controls of the same number based on age and sex . The researchers found a higher likelihood of lumbar spinal stenosis in diabetic patients ; those with hemoglobin A1c ≥7 % and ≥1 diabetes-related complication also had an elevated likelihood of having this diagnosis . The team determined that prolonged diabetes exposure increased the risk .
Having a diabetes diagnosis reduced median survival by around 4.5 years for both stenotic and non-stenotic patients ; spinal stenosis diagnosis alone minimally impacted survival . A multivariate analysis revealed a significantly increased risk of allcause mortality in patients with diabetes and lumbar spinal stenosis and those with diabetes without stenosis compared with controls .
Dr . Kadar , also affiliated with the Roth | McFarlane Hand & Upper Limb Centre , St . Joseph ’ s Hospital and Western University in Canada , explained to OTW , “ This work established the causal relationship of poor glycemic control and long-standing diabetes to high risk of spinal stenosis . In essence , this finding confirms the hypothesis that glycosylation ( the
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