To investigate the association of high preoperative hemoglobin A1c (HbA1c) with unplanned readmissions and infection/wound breakdown after minimally invasive lumbar spine surgery (MIS), highlighting its significance in the context of existing literature.
Key Findings:
High preoperative HbA1c (> 7.1%) is associated with increased rates of complications and readmissions, indicating a need for careful preoperative assessment.
The impact of HbA1c on outcomes in MIS lumbar spine surgery is less clear compared to open surgery, suggesting a potential area for further investigation.
Significant missing data for preoperative HbA1c (43%) was addressed using multiple imputations, which may affect the robustness of the findings.
Interpretation:
While elevated HbA1c is linked to poorer outcomes in spine surgery, its criticality in minimally invasive procedures may differ due to the reduced invasiveness and associated risks, warranting further clinical evaluation.
Limitations:
Retrospective design may introduce bias.
High missingness for HbA1c values could affect the validity of findings.
Generalizability may be limited to the single center study, which may not reflect broader populations.
Conclusion:
Further research is needed to clarify the role of preoperative HbA1c optimization in minimally invasive lumbar spine surgery outcomes, particularly in diverse patient populations.
