Literature DB >> 18628712

The effect of obesity on clinical outcomes after lumbar fusion.

Mladen Djurasovic1, Kelly R Bratcher, Steven D Glassman, John R Dimar, Leah Y Carreon.   

Abstract

STUDY
DESIGN: Retrospective cohort analysis.
OBJECTIVE: To investigate and compare back and leg pain, and health-related quality of life measures in obese patients undergoing lumbar spine fusion, and to compare the results to nonobese patients. SUMMARY OF BACKGROUND DATA: Obesity is a growing healthcare crisis in the United States and an increasing number of patients undergoing spinal surgery are obese. Obesity is also associated with low back pain. Some obese patients with significant structural spine problems may be dismissed as having their pain only coming from their weight. We compared patient outcomes in obese and nonobese patients undergoing lumbar fusion surgery.
METHODS: We retrospectively reviewed a single-center patient database of patients undergoing lumbar fusion and identified 270 patients with greater than 2-year outcome data. Body mass index (BMI) was calculated and patients were classified as obese (BMI >or= 30) or nonobese (BMI < 30). All patients completed Oswestry Disability Index (ODI), Short Form (SF)-36 questionnaires, and back and leg pain numerical rating scores before surgery and at 2 years. We compared clinical outcomes and complication rates in the 2 groups.
RESULTS: The overall study group consisted of 109 obese patients and 161 nonobese patients. Both the obese and nonobese patients demonstrated significant improvements in back pain, leg pain, SF-36 physical composite summary (PCS), and ODI scores (P < 0.001) at 2-year follow-up compared with baseline. There was no significant difference in the mean improvements seen in obese patients compared with nonobese patients with respect to back pain, leg pain, or SF-36 PCS or ODI scores. Both SF-36 PCS (P = 0.037) and ODI score (P = 0.028) at 2-year follow-up were better in the nonobese patients compared with the obese patients. Overall complication rates were slightly higher in the obese group (P = 0.045), predominantly because of wound-related complications.
CONCLUSION: Obese patients undergoing lumbar fusion achieve similar benefits to nonobese patients. Wound-related complications are more common in obese patients. Obese patients with otherwise good indications for lumbar fusion should not be denied this procedure because of their weight.

Entities:  

Mesh:

Year:  2008        PMID: 18628712     DOI: 10.1097/BRS.0b013e31817b8f6f

Source DB:  PubMed          Journal:  Spine (Phila Pa 1976)        ISSN: 0362-2436            Impact factor:   3.468


  39 in total

1.  Comparison of unilateral versus bilateral pedicle screw fixation in lumbar interbody fusion: a meta-analysis.

Authors:  Wenbin Ding; Yile Chen; Hui Liu; Jianru Wang; Zhaomin Zheng
Journal:  Eur Spine J       Date:  2013-11-22       Impact factor: 3.134

2.  Does obesity impact lumbar sagittal alignment and clinical outcomes after a posterior lumbar spine fusion?

Authors:  Jannat M Khan; Bryce A Basques; Kyle N Kunze; Gagan Grewal; Young Soo Hong; Coralie Pardo; Philip K Louie; Matthew Colman; Howard S An
Journal:  Eur Spine J       Date:  2019-08-16       Impact factor: 3.134

3.  The impact of body habitus on the surgical outcomes of transaxillary single-incision robotic thyroidectomy in papillary thyroid carcinoma patients.

Authors:  Sohee Lee; Seulkee Park; Cho Rok Lee; Haiyoung Son; Jungwoo Kim; Sang-Wook Kang; Jong Ju Jeong; Kee-Hyun Nam; Woong Youn Chung; Cheong Soo Park
Journal:  Surg Endosc       Date:  2013-01-24       Impact factor: 4.584

4.  Older Age and Leg Pain Are Good Predictors of Pain and Disability Outcomes in 2710 Patients Who Receive Lumbar Fusion.

Authors:  Chad E Cook; Anthony K Frempong-Boadu; Kristen Radcliff; Isaac Karikari; Robert Isaacs
Journal:  HSS J       Date:  2015-08-05

5.  Does obesity affect outcomes of treatment for lumbar stenosis and degenerative spondylolisthesis? Analysis of the Spine Patient Outcomes Research Trial (SPORT).

Authors:  Jeffrey A Rihn; Kristen Radcliff; Alan S Hilibrand; David T Anderson; Wenyan Zhao; Jon Lurie; Alexander R Vaccaro; Mitch K Freedman; Todd J Albert; James N Weinstein
Journal:  Spine (Phila Pa 1976)       Date:  2012-11-01       Impact factor: 3.468

6.  Understanding the Impact of Obesity on Short-term Outcomes and In-hospital Costs After Instrumented Spinal Fusion.

Authors:  Dominique M Higgins; Grant W Mallory; Ryan F Planchard; Ross C Puffer; Mohamed Ali; Marcus J Gates; William E Clifton; Jeffrey T Jacob; Timothy B Curry; Daryl J Kor; Jeremy L Fogelson; William E Krauss; Michelle J Clarke
Journal:  Neurosurgery       Date:  2016-01       Impact factor: 4.654

7.  Perioperative morbidity and complications in minimal access surgery techniques in obese patients with degenerative lumbar disease.

Authors:  Wolfgang Senker; Christian Meznik; Alexander Avian; Andrea Berghold
Journal:  Eur Spine J       Date:  2011-01-25       Impact factor: 3.134

Review 8.  Critical care of obese patients during and after spine surgery.

Authors:  Hossein Elgafy; Ryan Hamilton; Nicholas Peters; Daniel Paull; Ali Hassan
Journal:  World J Crit Care Med       Date:  2016-02-04

9.  What are the risk factors for surgical site infection after spinal fusion? A meta-analysis.

Authors:  Sebastien Pesenti; Tejbir Pannu; Jessica Andres-Bergos; Renaud Lafage; Justin S Smith; Steve Glassman; Marinus de Kleuver; Ferran Pellise; Frank Schwab; Virginie Lafage
Journal:  Eur Spine J       Date:  2018-08-20       Impact factor: 3.134

10.  Clinical and radiographic parameters that distinguish between the best and worst outcomes of scoliosis surgery for adults.

Authors:  Justin S Smith; Christopher I Shaffrey; Steven D Glassman; Leah Y Carreon; Frank J Schwab; Virginie Lafage; Vincent Arlet; Kai-Ming G Fu; Keith H Bridwell
Journal:  Eur Spine J       Date:  2012-10-18       Impact factor: 3.134

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