Evidence map›Paper›PMID 31759133›Full record

ArticleThe spine journal : official journal of the North American Spine Society2020

The effect of insulin dependent diabetes on bone metabolism and growth after spinal fusion.

Zachary NaPier, Linda E A Kanim, Trevor J Nelson, Khosrowdad Salehi, Yasaman Arabi, Juliane D Glaeser, Dmitriy Sheyn, Melodie F Metzger

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The spine journal : official journal of the North American Spine Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 19 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Zachary NaPierDepartment of Orthopedics, Cedars-Sinai, Los Angeles, CA, USA.
Linda E A KanimDepartment of Orthopedics, Cedars-Sinai, Los Angeles, CA, USA; Orthopedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Building 6006, Los Angeles, CA 90048, USA.
Trevor J NelsonDepartment of Orthopedics, Cedars-Sinai, Los Angeles, CA, USA; Cedars-Sinai Orthopedic Biomechanics Laboratory, Los Angeles, CA, USA.
Khosrowdad SalehiDepartment of Orthopedics, Cedars-Sinai, Los Angeles, CA, USA; Orthopedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Building 6006, Los Angeles, CA 90048, USA; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Yasaman ArabiDepartment of Orthopedics, Cedars-Sinai, Los Angeles, CA, USA; Orthopedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Building 6006, Los Angeles, CA 90048, USA; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Juliane D GlaeserDepartment of Orthopedics, Cedars-Sinai, Los Angeles, CA, USA; Orthopedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Building 6006, Los Angeles, CA 90048, USA; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Dmitriy SheynDepartment of Orthopedics, Cedars-Sinai, Los Angeles, CA, USA; Orthopedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Building 6006, Los Angeles, CA 90048, USA; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Surgery, Cedars-Sinai, Los Angeles, CA, USA; Department of Biomedical Sciences, Cedars-Sinai, Los Angeles, CA, USA.
Melodie F MetzgerDepartment of Orthopedics, Cedars-Sinai, Los Angeles, CA, USA; Cedars-Sinai Orthopedic Biomechanics Laboratory, Los Angeles, CA, USA. Electronic address: Melodie.Metzger@cshs.org.
Cedars-Sinai Medical Center · US

Funding

Induced pluripotent stem cell therapy for degenerated IVDK01AR071512 · NIAMS · CEDARS-SINAI MEDICAL CENTER · PI SHEYN, DMITRIY · 2018 to 2022
$595k
NIAMS NIH HHS K01 AR071512
6 · The paper itself

Abstract

STUDY

designExperimental animal model.

objectiveThe purpose of this study was to evaluate the hypothesis that insulin dependent diabetes mellitus (IDDM) will inhibit the formation of a solid bony union after spinal fusion surgery via an alteration of the microenvironment at the fusion site in a rat model. SUMMARY OF BACKGROUND DATA: Previous studies report diabetes mellitus (DM) and specifically IDDM as a risk factor for complications and poor surgical outcomes following spinal fusion.

methodsTwenty control and 22 diabetic rats were obtained at 5 weeks of age. At 20 weeks of age, all animals underwent posterolateral lumbar fusion surgery using a tailbone autograft with diabetic rats receiving an implantable time release insulin pellet. A subset of rats was sacrificed 1-week postsurgery for growth factor (PDGF, IGF-I, TGF-β, and VEGF) and proinflammatory cytokine ELISA analysis. All other rats were sacrificed 3-months postsurgery for fusion evaluation via manual palpation and micro CT. Glycated hemoglobin (HbA1c) was measured at surgery and sacrifice on all animals.

resultsCompared with healthy rats undergoing spinal fusion, rats with IDDM demonstrated a significant reduction in manual palpation fusion rates (16.7% vs. 43%, p<.05). Average bone mineral density, bone volume, and bone volume fraction were also significantly reduced and negatively correlated to blood glucose levels. IL-1B, IL-5, IL-10, TNF-α, and KC/GRO were significantly elevated in fusion beds of IDDM rats.

conclusionsThis study demonstrates that rats with IDDM demonstrate a reduced rate and quality of spinal fusion with increased local levels of inflammatory cytokines. Targeted modalities are required to improve bone healing in this growing, high-risk population. CLINICAL SIGNIFICANCE: This is the first translational animal model of IDDM to evaluate the rate and quality of spinal fusion while controlling for other surgical and patient-related risk factors. Our findings demonstrate the complex nature by which IDDM impairs bone healing and highlight the need for additional basic science research to further elucidate this mechanism in order to develop more effective therapeutic interventions.

Indexed as

Diabetes Mellitus, ExperimentalDiabetes Mellitus, Type 1Spinal DiseasesSpinal FusionAnimalsHumansLumbar VertebraeRatsDiabetesGrowth factorsInsulin dependenceNonunionPseudarthrosisSpinal fusion

Identifiers

PMID31759133
PMCPMC7234904
OpenAlexW2990329908

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.