STUDY DESIGN: Analysis of a combined prospective dataset. OBJECTIVE: To evaluate the impact of preoperative body mass index (BMI) on surgical outcomes in degenerative cervical myelopathy (DCM). SUMMARY OF BACKGROUND DATA: Although elevated BMI has been shown to have a deleterious impact on outcomes after lumbar spine surgery, limited evidence is available regarding its impact in DCM. METHODS: Analyses were completed using a combined North American/International prospective surgical DCM dataset from 26 participating centers. Outcome measures included Neck Disability Index (NDI), modified Japanese Orthopedic Association (mJOA) score, and Short Form- 36 (SF-36) scores at 1 year postoperatively. Bivariate and multivariable statistics were used to model the relationship between preoperative BMI, as both a continuous and categorical variable with these outcomes. RESULTS: Of 757 patients, mean BMI was 27.3 (±5.7) with 17 patients (3.5%) underweight, 271 patients (35.8%) normal weight, 275 patients (36.3%) overweight, and 194 patients (25.7%) obese. Controlling for preoperative mJOA, NDI, smoking status, age, and sex, elevated BMI was associated with increased neck disability at 1 year (P < 0.01). On average, NDI scores were 4.5 points higher (95% confidence interval, CI: 1.6-7.6) for overweight patients and 5.7 points higher (95% CI: 2.6-8.9) for obese patients compared with individuals of normal weight. Obese patients had 0.5 times odds (odds ratio, OR = 0.5, 95% CI: 0.3-0.8, P < 0.01) of showing improvement equal to the minimal clinically important difference of NDI compared with their normal weight counterparts. Although there were strong trends towards reduced SF-36 mental component scores and physical component scores with elevated BMI, no association was found between BMI and 1-year mJOA. CONCLUSION: Increased BMI, particularly obesity, was associated with increased postoperative disability. This represents a potentially modifiable risk factor which clinicians can target to optimize postoperative outcomes. LEVEL OF EVIDENCE: 2.
STUDY DESIGN: Analysis of a combined prospective dataset. OBJECTIVE: To evaluate the impact of preoperative body mass index (BMI) on surgical outcomes in degenerative cervical myelopathy (DCM). SUMMARY OF BACKGROUND DATA: Although elevated BMI has been shown to have a deleterious impact on outcomes after lumbar spine surgery, limited evidence is available regarding its impact in DCM. METHODS: Analyses were completed using a combined North American/International prospective surgical DCM dataset from 26 participating centers. Outcome measures included Neck Disability Index (NDI), modified Japanese Orthopedic Association (mJOA) score, and Short Form- 36 (SF-36) scores at 1 year postoperatively. Bivariate and multivariable statistics were used to model the relationship between preoperative BMI, as both a continuous and categorical variable with these outcomes. RESULTS: Of 757 patients, mean BMI was 27.3 (±5.7) with 17 patients (3.5%) underweight, 271 patients (35.8%) normal weight, 275 patients (36.3%) overweight, and 194 patients (25.7%) obese. Controlling for preoperative mJOA, NDI, smoking status, age, and sex, elevated BMI was associated with increased neck disability at 1 year (P < 0.01). On average, NDI scores were 4.5 points higher (95% confidence interval, CI: 1.6-7.6) for overweight patients and 5.7 points higher (95% CI: 2.6-8.9) for obesepatients compared with individuals of normal weight. Obesepatients had 0.5 times odds (odds ratio, OR = 0.5, 95% CI: 0.3-0.8, P < 0.01) of showing improvement equal to the minimal clinically important difference of NDI compared with their normal weight counterparts. Although there were strong trends towards reduced SF-36 mental component scores and physical component scores with elevated BMI, no association was found between BMI and 1-year mJOA. CONCLUSION: Increased BMI, particularly obesity, was associated with increased postoperative disability. This represents a potentially modifiable risk factor which clinicians can target to optimize postoperative outcomes. LEVEL OF EVIDENCE: 2.
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: Vincent Huang; Stephen P Miranda; Ryan Dimentberg; Kaitlyn Shultz; Scott D McClintock; Neil R Malhotra Journal: J Neurol Surg B Skull Base Date: 2021-02-04
Authors: Ali S Farooqi; Austin J Borja; Donald K E D Detchou; Gregory Glauser; Krista Strouz; Scott D McClintock; Neil R Malhotra Journal: Int J Spine Surg Date: 2022-05-25
Authors: Elliot D K Cha; Conor P Lynch; James M Parrish; Nathaniel W Jenkins; Shruthi Mohan; Cara E Geoghegan; Caroline N Jadczak; Kern Singh Journal: Int J Spine Surg Date: 2021-12
Authors: Ali S Farooqi; Starr Jiang; Austin J Borja; Donald K E D Detchou; Ryan Dimentberg; Kaitlyn Shultz; Scott D McClintock; Neil R Malhotra Journal: Cureus Date: 2021-11-29
Authors: Fabio Cofano; Giuseppe Di Perna; Daria Bongiovanni; Vittoria Roscigno; Bianca Maria Baldassarre; Salvatore Petrone; Fulvio Tartara; Diego Garbossa; Marco Bozzaro Journal: Global Spine J Date: 2021-06-15