Correlation between perioperative glycemic variability and early postoperative functional recovery in elderly patients with lumbar degenerative disease: A prospective cohort study

Perioperative glucose variability (GV) is one of the key factors of patient prognosis. This Prospective Cohort study aimed to evaluate the association between perioperative GV and early postoperative functional recovery in elderly patients undergoing surgery for lumbar degenerative diseases. Elderly patients who underwent lumbar spine surgery from October 2024 to April 2025 were included. The coefficient of variation (CV) of glucose was calculated as an indicator of GV. We categorized the CV into three groups based on tertiles. Regression models evaluated GV's impact on ODI and JOA. Subgroup analyses validated findings. A total of 171 patients (mean age 72.09 years; 44.44% male) were included in this study. GV showed a significant negative correlation with 3-month postoperative JOA (r=-0.209, P < 0.01) and a significant positive correlation with ODI (r = 0.339, P < 0.01). Multivariate regression analysis further identified GV as an independent predictor of decreased JOA scores (P = 0.035) and increased ODI scores (P < 0.001) in the early postoperative period. Subgroup analyses confirmed the consistency of the associations between GV and postoperative ODI and JOA across various subgroups. GV is closely related to early postoperative functional recovery in elderly patients with lumbar degenerative disease. Monitoring GV may be a valuable approach to predict the early postoperative functional outcomes in this patient population, potentially guiding more personalized treatment strategies and postoperative management to improve their early postoperative functional status and quality of life.