{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T02:11:15Z","timestamp":1793239875014,"version":"4.5.0"},"reference-count":31,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Anterior cervical discectomy and fusion (ACDF) is a common treatment for cervical radiculopathy and myelopathy. While generally effective, diabetes mellitus may increase postoperative complications and healthcare costs. This study evaluated the impact of type 2 diabetes on perioperative outcomes in ACDF patients. Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample (2016\u20132019), including 85,585 single-level ACDF patients. Propensity score matching (PSM) was applied, creating two balanced cohorts (16,260 diabetic and 16,260 non-diabetic patients). Outcomes analyzed included postoperative complications, length of stay, hospital charges, and mortality. Results: Diabetic patients had significantly higher risks of ACDF-specific complications, including cerebrospinal fluid leaks (2\u00d7), dysphagia (2.5\u00d7), dysphonia (2.9\u00d7), and cervical spinal cord injury (5\u00d7). General complications were also increased, with higher rates of pulmonary embolism (2.4\u00d7), sepsis (3\u00d7), stroke (3\u00d7), pneumonia (3.3\u00d7), and heart failure (12\u00d7). Diabetic patients had longer hospital stays (1.99 vs. 1.79 days, p &lt; 0.001) and higher hospital charges (USD 71,884 vs. USD 67,998, p = 0.004). Conclusions: T2DM significantly increases postoperative risks, length of stay, and costs for ACDF patients. Optimized perioperative management and glucose control are essential to improve outcomes in this high-risk population.<\/jats:p>","DOI":"10.3390\/jcm14093039","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T09:39:47Z","timestamp":1745833187000},"page":"3039","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Impact of Diabetes on Outcomes in Anterior Cervical Discectomy and Fusion (ACDF)"],"prefix":"10.3390","volume":"14","author":[{"given":"David","family":"Maman","sequence":"first","affiliation":[{"name":"Carmel Medical Center, Haifa 3436212, Israel"},{"name":"Faculty of Medicine, Technion Israel Institute of Technology, Haifa 2611001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assil","family":"Mahamid","sequence":"additional","affiliation":[{"name":"Hillel Yaffe Medical Center, Hadera 3810101, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Nisanov","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Technion Israel Institute of Technology, Haifa 2611001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4406-4262","authenticated-orcid":false,"given":"Oluwaseun","family":"Fagbamila","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Saint James School of Medicine, Kingstown VC0100, Saint Vincent and the Grenadines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Sleiman","sequence":"additional","affiliation":[{"name":"Carmel Medical Center, Haifa 3436212, Israel"},{"name":"Faculty of Medicine, Technion Israel Institute of Technology, Haifa 2611001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsen","family":"Shpigelman","sequence":"additional","affiliation":[{"name":"Carmel Medical Center, Haifa 3436212, Israel"},{"name":"Faculty of Medicine, Technion Israel Institute of Technology, Haifa 2611001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6466-6420","authenticated-orcid":false,"given":"Yaron","family":"Berkovich","sequence":"additional","affiliation":[{"name":"Carmel Medical Center, Haifa 3436212, Israel"},{"name":"Faculty of Medicine, Technion Israel Institute of Technology, Haifa 2611001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100","DOI":"10.25259\/SNI-191-2019","article-title":"A review of complication rates for anterior cervical diskectomy and fusion (ACDF)","volume":"10","author":"Epstein","year":"2019","journal-title":"Surg. 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