Evidence map›Paper›PMID 39751814›Full record

SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025

The economic burden of diabetes in spinal fusion surgery: a systematic review and meta-analysis.

Gonzalo Mariscal, Rick C Sasso, John E O'Toole, Christopher D Chaput, Michael P Steinmetz, Paul M Arnold, Christopher D Witiw, W Bradley Jacobs, James S Harrop

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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

9 authors.

Gonzalo MariscalInstitute for Research on Musculoskeletal Disorders, Valencia Catholic University, Valencia, Spain. Gonzalo.Mariscal@mail.ucv.es.ORCID 0000-0002-5166-198X
Rick C SassoDepartment Orthopaedic Surgery, Indiana Spine Group, Indiana University School of Medicine, Carmel, Indiana, USA.
John E O'TooleRush University Medical Center, Chicago, Illinois, USA.
Christopher D ChaputDepartment of Orthopedics, UT Health San Antonio, San Antonio, Texas, USA.
Michael P SteinmetzNeurological Institute, Department of Neurosurgery, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA.
Paul M ArnoldDepartment of Neurological Surgery, Loyola University Chicago, Chicago, Illinois, USA.
Christopher D WitiwDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
W Bradley JacobsCalgary Spine Program, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
James S HarropDepartments of Neurological and Orthopedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Funding

Cerapedics Inc. Cerapedics Inc.
6 · The paper itself

Abstract

purposeThis study aimed at comparing the costs of spinal fusion surgery between patients with and without diabetes.

methodsFollowing PRISMA guidelines, a systematic search of four databases was conducted. A meta-analysis was performed on comparative studies examining diabetic versus non-diabetic adults undergoing cervical/lumbar fusion in terms of cost. Heterogeneity was assessed using the I2 test. Standardized mean differences (SMD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model in the presence of heterogeneity.

resultsTwenty-two studies were included in this meta-analysis. Standardized costs were significantly higher in the diabetic group (SMD 0.02, 95% CI 0.01 to 0.03, p < 0.05). The excess cost per diabetic patient undergoing spinal fusion surgery was estimated to be $2,492 (95% CI: $1,620 to $3,363). The length of stay (LOS) was significantly longer in the diabetes group (MD 0.42, 95% CI 0.24 to 0.60, p < 0.001). No significant difference was observed in intensive care unit admission between the groups (OR 4.15, 95% CI 0.55 to 31.40, p > 0.05). Reoperation showed no significant differences between the groups (OR 1.14, 95% CI 0.96 to 1.35, p > 0.05). However, 30-day and 90-day readmissions were significantly higher in the diabetes group: (OR 1.42, 95% CI 1.24 to 1.62, p < 0.05) and (OR 1.39, 95% CI 1.15 to 1.68, p < 0.001), respectively. Non-routine or non-home discharge was also significantly higher in the diabetes group (OR 1.89, 95% CI 1.67 to 2.13, p < 0.001).

conclusionPatients with diabetes undergoing spinal fusion surgery had increased costs, prolonged LOS, increased 30-day/90-day readmission rates, and more frequent non-routine discharges.

Indexed as

Cost of IllnessDiabetes MellitusHealth Care CostsSpinal FusionHumansLength of StayCost analysisDiabetesHospital costsResource utilizationSpinal fusion

Identifiers

PMID39751814

What OpenQuestion holds

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Registered trials

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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.