title: Observations in the diagnosis of cervical myelopathy in patients suffering from diabetes mellitus.
abstract: OBJECTIVE
  To identify any observations that could aid in the diagnosis of cervical myelopathy in patients suffering from diabetes mellitus (DM). We compared the preoperative neurological findings in patients with cervical myelopathy among non-diabetics, mild diabetics and severe diabetics.
  
  
  METHODS
  A retrospective comparative study.
  
  
  METHODS
  Department of Orthopaedic Surgery, Wakayama Medical University, Japan.
  
  
  METHODS
  We retrospectively reviewed 111 patients who had undergone laminoplasty for cervical compressive myelopathy: 56 without DM and 29 with severe diabetes more than 10 years of medication; more than 7.0% HbA1c; diabetic retinopathy; and delayed conduction velocity of peripheral nerves. For preoperative neurological assessment we compared the following among the three groups: the 10 s test whereby the myelopathy in the hand was quantified; sensory disturbance; deep tendon reflexes; Hoffmann's, Trömner's and Babinski's reflexes; and bladder dysfunction.
  
  
  RESULTS
  There was no significant difference preoperatively in the 10 s test between the groups. Deep tendon reflexes were significantly decreased in group S. There were no significant differences in sensory disturbance and bladder dysfunction. Although Hoffmann's and Trömner's reflexes significantly disappeared in group S, there was no significant difference in positivity of Babinski's reflex between the groups.
  
  
  CONCLUSIONS
  The 10 s test and Babinski's reflex are helpful for the diagnosis of cervical myelopathy in patients suffering from DM.
authors.affiliation: Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan. motohiro2doctor@yahoo.co.jp
authors.forename: M
authors.initials: M
authors.lastname: Okada
authors.forename: A
authors.initials: A
authors.lastname: Minamide
authors.forename: M
authors.initials: M
authors.lastname: Yoshida
authors.forename: M
authors.initials: M
authors.lastname: Kawakami
authors.forename: Y
authors.initials: Y
authors.lastname: Enyo
authors.forename: T
authors.initials: T
authors.lastname: Endo
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery; D048909:Diabetes Complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D019637:Orthopedic Procedures; D001405:Reflex, Babinski; D012026:Reflex, Stretch / Q000502:physiology; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology; D013117:Spinal Cord Compression / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000209:etiology; D016055:Urinary Retention / Q000209:etiology / Q000503:physiopathology; D016138:Walking
chemical_list: D006442:Glycated Hemoglobin