{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T01:31:44Z","timestamp":1793323904713,"version":"4.5.0"},"reference-count":20,"publisher":"Open Medical Publishing","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background<\/jats:title>\n Diabetes is a well-established risk factor for postoperative complications following lumbar fusion; however, the independent impact of diabetic neuropathy on outcomes after single-level posterolateral lumbar fusion (PLF) remains incompletely defined.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective cohort study was performed using a multicenter database of adults undergoing single-level PLF. Patients were stratified into three groups: non-diabetic, diabetic without neuropathy, and diabetic with neuropathy. Propensity score matching was used to balance demographics and comorbidities, generating three matched comparisons. Ninety-day medical and two-year mechanical and surgical complications were compared using risk ratios (RRs) with 95% confidence intervals (CIs).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among patients without neuropathy, diabetes was associated with higher 90-day postoperative infection (5.0% vs 4.0%, RR 1.25), sepsis (2.3% vs 1.7%, RR 1.33), and wound disruption (3.8% vs 2.9%, RR 1.31). At two years, this group had higher implant-associated infection (2.9% vs 2.3%, RR 1.26) and revision surgery (6.5% vs 5.7%, RR 1.14), with similar pseudarthrosis. Patients with diabetic neuropathy had substantially higher rates of infection, sepsis, wound disruption, pneumonia, mechanical complications, implant-associated infection, and revision surgery, with comparable pseudarthrosis. Direct comparison of diabetic patients with vs without neuropathy showed neuropathy independently increased postoperative infection, wound disruption, implant-associated infection, and revision surgery, with similar thromboembolic events and pseudarthrosis.<\/jats:p>\n # Conclusions<\/jats:p>\n Diabetes increases short-term medical and long-term surgical complications following single-level PLF, and coexisting diabetic neuropathy further amplifies these risks, underscoring the importance of neuropathy status in preoperative risk and perioperative management.<\/jats:p>\n <\/jats:sec>","DOI":"10.52965\/001c.159613","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:34:35Z","timestamp":1775090075000},"source":"Crossref","is-referenced-by-count":1,"title":["Diabetes and Diabetic Neuropathy Significantly Increase Short- and Long-Term Complications Following Single-Level Posterolateral Lumbar Fusion: A Propensity- Matched Cohort Study"],"prefix":"10.52965","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6256-8755","authenticated-orcid":true,"given":"Abdel Kareem","family":"Hilo","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01070mq45","id-type":"ROR","asserted-by":"publisher"}],"name":"Wayne State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahya","family":"Haj Hamad","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/016tfm930","id-type":"ROR","asserted-by":"publisher"}],"name":"The University of Texas Medical Branch at Galveston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashar","family":"Jawich","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01070mq45","id-type":"ROR","asserted-by":"publisher"}],"name":"Wayne State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Forbes","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01070mq45","id-type":"ROR","asserted-by":"publisher"}],"name":"Wayne State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Harhash","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01070mq45","id-type":"ROR","asserted-by":"publisher"}],"name":"Wayne State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Mohammad","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01070mq45","id-type":"ROR","asserted-by":"publisher"}],"name":"Wayne State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alqasim","family":"Elnaggar","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01070mq45","id-type":"ROR","asserted-by":"publisher"}],"name":"Wayne State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Almaat","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01070mq45","id-type":"ROR","asserted-by":"publisher"}],"name":"Wayne State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haytham","family":"Alqasmi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01070mq45","id-type":"ROR","asserted-by":"publisher"}],"name":"Wayne State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyang","family":"Chu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05gehxw18","id-type":"ROR","asserted-by":"publisher"}],"name":"Detroit Medical Center","department":["Department of Orthopedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Vaidya","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05gehxw18","id-type":"ROR","asserted-by":"publisher"}],"name":"Detroit Medical Center","department":["Department of Orthopedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"30777","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"issue":"4","key":"ref1","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1097\/BRS.0b013e3181ef9d8c","article-title":"The impact of diabetes on the outcomes of surgical and nonsurgical treatment of patients in the spine patient outcomes research trial","volume":"36","author":"M. 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Luo","year":"2022","journal-title":"Int J Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2415","DOI":"10.2147\/TCRM.S185221","article-title":"The effect of diabetes on perioperative complications following spinal surgery: a meta-analysis","volume":"14","author":"W. Luo","year":"2018","journal-title":"Ther Clin Risk Manag"},{"issue":"12","key":"ref17","doi-asserted-by":"publisher","first-page":"2726","DOI":"10.1097\/CORR.0000000000001823","article-title":"Is Uncontrolled Diabetes Mellitus Associated with Incidence of Complications After Posterior Instrumented Lumbar Fusion? A National Claims Database Analysis","volume":"479","author":"T. Zhuang","year":"2021","journal-title":"Clin Orthop Relat Res"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-87615-y","article-title":"Diabetes is associated with greater leg pain and worse patient-reported outcomes at 1 year after lumbar spine surgery","author":"K. Nagata","year":"2021","journal-title":"Sci Rep"},{"issue":"17","key":"ref19","doi-asserted-by":"publisher","first-page":"E347","DOI":"10.1097\/BRS.0000000000005396","article-title":"Adverse Impact of Diabetes on Spine Fusion and Patient-Reported Outcomes: A Systematic Review and Meta-analysis","volume":"50","author":"M. P. Steinmetz","year":"2025","journal-title":"Spine (Phila Pa 1976)"},{"issue":"16","key":"ref20","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1097\/BRS.0000000000004703","article-title":"Preoperative HbA1c and Postoperative Outcomes in Spine Surgery: A Systematic Review and Meta-Analysis","volume":"48","author":"X. 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