Evidence mapPaperPMID 41205101Full record

ArticleActa neurochirurgica2025

Preoperative hemoglobin A1c and minimally invasive lumbar spine surgery: is it as critical as we think.

Yifei Sun, Sasha Howell, Lucia D Juarez, B Grey Vandeberg, Nicholas M B Laskay, Jovanna Tracz, James Mooney, Jakub Godzik

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Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
field-weighted citation impact
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2 · The registry

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Yifei SunHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Sasha HowellDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Lucia D JuarezDivision of General Internal Medicine and Population Science, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
B Grey VandebergDivision of General Internal Medicine and Population Science, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Nicholas M B LaskayDivision of General Internal Medicine and Population Science, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Jovanna TraczDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
James MooneyDepartment of Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA.
Jakub GodzikDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA. jgodzik@uabmc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMinimally invasive approaches to lumbar spine surgery are increasingly popular. Current guidelines highlight the importance of preoperative HbA1c in optimizing spine surgery outcomes. However, the role of preoperative HbA1c in minimally invasive lumbar spine surgery remains unclear.

objectivesWe sought to assess the association of HbA1c with readmissions, reoperations, and complications following minimally invasive lumbar spine surgery.

methodsWe retrospectively reviewed all adult patients at a single institution from 2011 to 2023 who underwent minimally invasive lumbar decompression or decompression with instrumented fusion using CPT and ICD9/10 codes. Multivariate logistic regressions were performed to assess the effect of high HbA1c on readmissions and reoperations.

resultsIn total, 1013 [median age 64 (IQR 54-71)] patients met the inclusion criteria. The median preoperative HbA1c was 5.99% (IQR 5.62 - 6.39). Upon multivariate regression analysis adjusting for frailty, socioeconomic status, and other confounders, patients with high HbA1c (> 7.1) had increased odds of unplanned readmission within 90 days (OR 2.02, 95% CI 1.10- 3.56, p = 0.019) and reoperation within 90 days (OR 2.82, 95%CI 1.14-6.31) of the index operation. Patients with high HbA1c also had increased odds of requiring reoperation due to persistent symptoms (OR 2.9, 95%CI 0.91-7.87, p = 0.048). After propensity score matching, patients with high HbA1c also had prolonged hospital lengths of stay (1.32 days vs 1.24 days, p = 0.006), post operative UTI (4.7% vs 0.9%, p = 0.034).

conclusionsOur results suggest high preoperative HbA1C may be associated with increased rates of readmission and reoperation following minimally invasive lumbar spine surgery. Preoperative HbA1C control may be indicated for surgical optimization in minimally invasive lumbar spine surgery.

Indexed as

Decompression, SurgicalGlycated HemoglobinLumbar VertebraeMinimally Invasive Surgical ProceduresPostoperative ComplicationsSpinal FusionAgedFemaleHumansMaleMiddle AgedPatient ReadmissionReoperationRetrospective StudiesGlycated Hemoglobinhemoglobin A1c protein, humanComplicationsHbA1cMinimally invasiveReadmissionsReoperation

Identifiers

PMID41205101
PMCPMC12596392

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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 Socratic graph.