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Electrophysiological evidence of diabetes’ impacts on central conduction recoveries in degenerative cervical myelopathy after surgery

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Abstract

Objectives

To assess the impact of diabetes mellitus (DM) on the postoperative motor and somatosensory functional recoveries of degenerative cervical myelopathy (DCM) patients.

Methods

Motor and somatosensory evoked potentials (MEP and SSEPs) and modified Japanese Orthopedic Association (mJOA) scores were recorded in 27 diabetic (DCM-DM group) and 38 non-diabetic DCM patients (DCM group) before and 1 year after surgery. The central motor (CMCT) and somatosensory (CSCT) conduction time were recorded to evaluate the conductive functions of the spinal cord.

Results

The mJOA scores, CMCT and CSCT improved (t test, p < 0.05) in both of the DCM-DM and DCM groups 1 year after surgery. The mJOA recovery rate (RR) and CSCT recovery ratio were significantly worse (t test, p < 0.05) in the DCM-DM group compared to the DCM group. DM proved to be a significant independent risk factor for poor CSCT recovery (OR = 4.52, 95% CI 2.32–7.12) after adjusting for possible confounding factors. In DCM-DM group, CSCT recovery ratio was also correlated with preoperative HbA1 level (R =  − 0.55, p = 0.003). Furthermore, DM duration longer than 10 years and insulin dependence were risk factors for lower mJOA, CMCT and CSCT recoveries among all DCM-DM patients (t test, p < 0.05).

Conclusions

DM may directly hinders spinal cord conduction recovery in DCM patients after surgery. Corticospinal tract impairments are similar between DCM and DCM-DM patients, but significantly worsened in chronic or insulin-dependent DM patients. The dorsal column is more sensitively affected in all DCM-DM patients. Deeper investigation into the mechanisms and neural regeneration strategies is needed.

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Funding

Natural Science Foundation of Guangdong Province (2022A1515012557), Guangzhou Science and Technology Program Key Projects (202103000053) and National Natural Science Foundation of China (82102636).

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Author notes

  1. Zhengran Yu, Chong Chen and Tao Yu have contributed equally to this work.

Authors and Affiliations

  1. Department of Spine Surgery, Orthopedics Center of Guangdong Provincial People’s Hospital and Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, People’s Republic of China

    Zhengran Yu, Chong Chen, Tao Yu, Yongyu Ye, Xiaoqing Zheng, Shiqiang Zhan, Shixing Zeng & Yunbing Chang

  2. Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, People’s Republic of China

    Xuenong Zou

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  1. Zhengran Yu
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Contributions

ZY, CC and TY analyzed the data, drafted and revised the manuscript. YY revised the manuscript critically for important intellectual content. YC and XZ made substantial contributions to the conception and design of the study and provided final approval of the version to be published. SZ and SZ were involved in the acquisition of data. All authors read and approved the final manuscript.

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Correspondence to Xuenong Zou.

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Yu, Z., Chen, C., Yu, T. et al. Electrophysiological evidence of diabetes’ impacts on central conduction recoveries in degenerative cervical myelopathy after surgery. Eur Spine J 32, 2101–2109 (2023). https://doi.org/10.1007/s00586-023-07605-8

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