Charalampis Giannadakis1, Ulf S Nerland2, Ole Solheim3, Asgeir S Jakola4, Michel Gulati5, Clemens Weber6, Øystein P Nygaard7, Tore K Solberg8, Sasha Gulati9. 1. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: charalampis.giannadakis@ntnu.no. 2. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway. 3. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; National Advisory Unit in Ultrasound and Image-Guided Surgery, Trondheim, Norway. 4. National Advisory Unit in Ultrasound and Image-Guided Surgery, Trondheim, Norway; Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden. 5. Department of Surgery, Ålesund Hospital, Ålesund, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway. 6. National Advisory Unit on Spinal Surgery Center for Spinal Disorders, St. Olavs University Hospital, Trondheim, Norway; Department of Neurosurgery, Stavanger University Hospital, Stavanger, Norway. 7. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; National Advisory Unit on Spinal Surgery Center for Spinal Disorders, St. Olavs University Hospital, Trondheim, Norway. 8. Department of Neurosurgery, University Hospital of Northern Norway, Tromsø, Norway; The Norwegian National Registry for Spine Surgery, University Hospital of Northern Norway, Tromsø, Norway. 9. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; National Advisory Unit on Spinal Surgery Center for Spinal Disorders, St. Olavs University Hospital, Trondheim, Norway; Norwegian Centre of Competence in Deep Brain Stimulation for Movement Disorders, St. Olavs University Hospital, Trondheim, Norway.
Abstract
OBJECTIVE: To evaluate the association between obesity and outcomes 1 year after laminectomy or microdecompression for lumbar spinal stenosis (LSS). METHODS: The primary outcome measure was the Oswestry Disability Index (ODI). Obesity was defined as body mass index (BMI) ≥ 30. Prospective data were retrieved from the Norwegian Registry for Spine Surgery. RESULTS: For all patients (n = 1473) the mean improvement in ODI at 1 year was 16.7 points (95% CI 15.7-17.7, P < 0.001). The improvement in ODI was 17.5 points in nonobese and 14.3 points in obese patients (P = 0 .007). Obese patients were less likely to achieve a minimal clinically important difference in ODI (defined as ≥ 8 points improvement) than nonobese patients (62.2 vs. 70.3%, P = 0.013). Obesity was identified as a negative predictor for ODI improvement in a multiple regression analysis (P < 0.001). Nonobese patients experienced more improvement in both back pain (0.7 points, P = 0.002) and leg pain (0.8 points, P = 0.001) measured by numeric rating scales. Duration of surgery was shorter for nonobese patients for both single- (79 vs. 89 minutes, P = 0.001) and 2-level (102 vs. 114 minutes, P = 0.004) surgery. There was no difference in complication rates (10.4% vs. 10.8%, P = 0.84). There was no difference in length of hospital stays for single- (2.7 vs. 3.0 days, P = 0.229) or 2-level (3.5 vs. 3.6 days, P = 0.704) surgery. CONCLUSIONS: Both nonobese and obese patients report considerable clinical improvement 1 year after surgery for LSS, but improvement was less in obese patients. Obese patients were less likely to achieve a minimal clinically important difference.
OBJECTIVE: To evaluate the association between obesity and outcomes 1 year after laminectomy or microdecompression for lumbar spinal stenosis (LSS). METHODS: The primary outcome measure was the Oswestry Disability Index (ODI). Obesity was defined as body mass index (BMI) ≥ 30. Prospective data were retrieved from the Norwegian Registry for Spine Surgery. RESULTS: For all patients (n = 1473) the mean improvement in ODI at 1 year was 16.7 points (95% CI 15.7-17.7, P < 0.001). The improvement in ODI was 17.5 points in nonobese and 14.3 points in obesepatients (P = 0 .007). Obesepatients were less likely to achieve a minimal clinically important difference in ODI (defined as ≥ 8 points improvement) than nonobese patients (62.2 vs. 70.3%, P = 0.013). Obesity was identified as a negative predictor for ODI improvement in a multiple regression analysis (P < 0.001). Nonobese patients experienced more improvement in both back pain (0.7 points, P = 0.002) and leg pain (0.8 points, P = 0.001) measured by numeric rating scales. Duration of surgery was shorter for nonobese patients for both single- (79 vs. 89 minutes, P = 0.001) and 2-level (102 vs. 114 minutes, P = 0.004) surgery. There was no difference in complication rates (10.4% vs. 10.8%, P = 0.84). There was no difference in length of hospital stays for single- (2.7 vs. 3.0 days, P = 0.229) or 2-level (3.5 vs. 3.6 days, P = 0.704) surgery. CONCLUSIONS: Both nonobese and obesepatients report considerable clinical improvement 1 year after surgery for LSS, but improvement was less in obesepatients. Obesepatients were less likely to achieve a minimal clinically important difference.
Authors: Gennadiy A Katsevman; Scott D Daffner; Nicholas J Brandmeir; Sanford E Emery; John C France; Cara L Sedney Journal: Spine J Date: 2019-12-24 Impact factor: 4.166
Authors: Tamara Herold; Ralph Kothe; Christoph J Siepe; Oliver Heese; Wolfgang Hitzl; Andreas Korge; Karin Wuertz-Kozak Journal: Eur Spine J Date: 2021-02-27 Impact factor: 3.134
Authors: Binwu Sheng; Chaoling Feng; Donglan Zhang; Hugh Spitler; Lu Shi Journal: Int J Environ Res Public Health Date: 2017-02-13 Impact factor: 3.390