Does a Minimally Invasive Surgical Technique Affect Intraoperative and Post-operative Blood Glucose Levels in Adolescent Idiopathic Scoliosis Correction?

Introduction: To examine if a minimally invasive surgical (MIS) technique influences perioperative blood glucose levels of patients undergoing surgical correction for Adolescent Idiopathic Scoliosis (AIS).

Methods: The charts of 35 patients undergoing surgical correction for AIS were reviewed. Patients were divided into two cohorts based on surgical approach, open or MIS. Clinical and demographic variables were collected.

Results: There were 18 and 17 patients in open and MIS, respectively. Mean age and Body Mass Index were similar in both groups. Overall presence of an endocrine issue was 60%. Of these, 95% were abnormal vitamin D levels (8 deficiency, 12 insufficiency) and one patient had a diagnosis of hypothyroidism. The incidence of endocrine issues varied significantly in the open (n= 14) versus the MIS (n=7). Mean preoperative glucose was 89.3±13.1mg/dL, with no significant difference between MIS and Open. There was no significant difference in mean intraoperative blood glucose levels between MIS (89.7± 8mg/dL) and Open (90.4±11.8mg/dL). Blood glucose levels were highest on postoperative day 1, mean 117.1±12.5mg/dL, and consistently decreased over postoperative days 2 and 3, 106.6±16.3mg/dL and 99.3±8.4mg/dL respectively. There was no significant difference in postoperative blood glucose levels between the two groups.

Conclusion : Though there was a significantly higher incidence of endocrine issues in the open, there was no statistical difference in blood glucose levels at any of the defined intervals between the two groups. Blood glucose was the highest on POD1 in both groups and tapered down each subsequent postoperative day in alignment with literature.