Evidence map›Paper›PMID 41219931›Full record

ArticleJournal of orthopaedic surgery and research2025

Effect of diabetes mellitus on plantar pressure improvement after anterior cervical spine surgery in patients with cervical spondylotic myelopathy.

Xuhong Zhang, Zichuan Wu, Junbin Liu, Junzhe Sheng, Hanlin Song, Baifeng Sun, Chen Xu, Min Qi, Yang Liu

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Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Xuhong Zhang *Department of Spine Surgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, 200003, P. R. China.
Zichuan Wu *Department of Orthopedics, Ningbo No.6 Hospital, NingBo, Zhejiang, China.
Junbin Liu *Department of Spine Surgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, 200003, P. R. China.
Junzhe ShengDepartment of Spine Surgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, 200003, P. R. China.
Hanlin SongDepartment of Spine Surgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, 200003, P. R. China.
Baifeng SunDepartment of Spine Surgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, 200003, P. R. China.
Chen XuDepartment of Spine Surgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, 200003, P. R. China.
Min QiDepartment of Spine Surgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, 200003, P. R. China. qiminspine@163.com.
Yang LiuDepartment of Spine Surgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, 200003, P. R. China. lyspinesurgery@163.com.

Funding

Shanghai Municipal Education Commission 2023 Science and Technology 05-60
6 · The paper itself

Abstract

backgroundPlantar pressure distribution is a key marker of lower limb neuromuscular function and gait stability in patients with cervical spondylotic myelopathy (CSM). Diabetes mellitus (DM) impairs neurological recovery, but its impact on postoperative plantar pressure improvement in CSM remains unclear. This study explored the association between preoperative glycated hemoglobin (HbA1c) and long-term plantar pressure changes after anterior cervical surgery in CSM patients with DM.

methodsWe retrospectively analyzed 71 CSM patients with DM who underwent anterior cervical discectomy and fusion (ACDF) between 2018 and 2022, with 2-year follow-up. Primary outcomes included 2-year changes in medial (ΔMFP2) and lateral foot pressure (ΔLFP2). Correlations between preoperative HbA1c and plantar pressure improvement were analyzed using linear regression. Binary logistic regression identified risk factors for poor recovery, and ROC analysis determined the optimal HbA1c threshold.

resultsPreoperative HbA1c was an independent predictor of ΔMFP2 (P = 0.012) and ΔLFP2 (P = 0.026) at 2 years, with higher HbA1c associated with smaller improvements. No significant correlation was observed between HbA1c and 6-month plantar pressure changes (P > 0.05). ROC analysis identified preoperative HbA1c ≤ 6.8% as optimal for favorable ΔMFP2 (AUC = 0.72, sensitivity = 71.4%, specificity = 75.0%) and ≤ 6.7% for ΔLFP2 (AUC = 0.68, sensitivity = 68.2%, specificity = 70.3%). Plantar pressure improvement strongly correlated with 2-year JOA score recovery (r = 0.68 and 0.71, P < 0.001).

conclusionsPreoperative HbA1c levels predict long-term plantar pressure improvement after ACDF in CSM patients with DM. Maintaining HbA1c ≤ 6.7% may optimize medial/lateral foot pressure recovery, supporting stringent perioperative glycemic control.

Indexed as

Cervical VertebraeDiabetes MellitusDiskectomyFootSpinal Cord DiseasesSpinal FusionSpondylosisAdultAgedFemaleFollow-Up StudiesGlycated HemoglobinHumansMaleMiddle AgedPressureGlycated Hemoglobinhemoglobin A1c protein, humanAnterior cervical surgeryCervical spondylotic myelopathyDiabetes mellitusGlycated hemoglobinPlantar pressure

Identifiers

PMID41219931
PMCPMC12606794

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