Association between diabetes, obesity, and quality of life in preoperative patients with degenerative cervical myelopathy: A cross-sectional study.

ABSTRACT

Background and Aims: Degenerative cervical myelopathy (DCM) is a debilitating condition characterized by compression of the cervical spinal cord, leading to neurological deficits. This study aimed to investigate the association between comorbidities like diabetes mellitus (DM) and obesity and quality of life (QOL) in preoperative patients with DCM, and to examine the distribution of pain and numbness. Methods: A cross-sectional study with 86 preoperative patients with DCM was conducted. Patient-reported outcome measures (PROMs) including Core Outcome Measure Index for the neck (COMI-Neck), Neck Disability Index (NDI), EQ-5D-3L, SF-12v2 assessed QOL, and baseline characteristics were collected. Patients were categorized by diabetic and obesity status, resulting in 17 with and 69 without DM, and 27 obese, 59 nonobese patients. In the statistical analysis, we compared PROMs and baseline characteristics, and conducted MANCOVA to investigate the association of DM and obesity with PROMs. Results: The study found no significant differences in preoperative QOL between patients with and without DM or obesity. Additionally, the results of MANCOVA indicated that neither DM nor obesity alone, nor their combination, had an association with the total scores of PROMs. In each group, the Symptom-specific well-being score on the COMI-Neck was notably high, implying distressing current symptoms (median 10). On the NDI, the median score for pain intensity, lifting, work, and recreation subitems was 3. Pain was predominantly reported in the neck and lower back, while numbness was more prevalent in the peripheral regions of the upper and lower limbs. Conclusion: Preoperative QOL was not significantly affected by the presence of DM and/or obesity. DCM-related symptoms may mask the associations with these comorbidities. Regardless of the preoperative condition, it is important to address the PROMs items that posed challenges before surgery.