Voitto Järvimäki1, Hannu Kautiainen2, Maija Haanpää3, Seppo Alahuhta4, Merja Vakkala4. 1. Department of Anaesthesiology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland. Electronic address: voitto.jarvimaki@ppshp.fi. 2. Department of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland. 3. Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland; Mutual Insurance Company Etera, Helsinki, Finland. 4. Department of Anaesthesiology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
Abstract
PURPOSE: To investigate the effect of obesity on outcome in lumbar discectomy. METHODS: A cross-sectional postal survey; a self-made questionnaire, Beck depression inventory IA (BDI IA) and the Oswestry low back disability questionnaire (ODI) were sent to the patients, who had undergone lumbar disc surgery in the Oulu University Hospital between June 2005 and May 2008. Patients were divided into three groups according to BMI: normal, pre-obese and obese. The ODI was also examined in the framework of the international classification of functioning, disability and health (ICF) to investigate its ability to describe various dimensions of functioning (body structure and functions, activities and participation). RESULTS: The postal survey was sent to 642 patients, of whom 355 (55%) replied. Males dominated in the pre-obese (66%) and obese (62%) groups (p=0.01). Normal-weighted and pre-obese patients had lower BDI scores compared to obese patients (mean BDI: 8.0, 7.6, 11.2, respectively, p=0.035). Total ODI score was highest in the obese group compared to normal-weighted or pre-obese (20.3, 18.6, 26.4, respectively, p=0.011). When ODI was linked to the ICF there were significant differences in all activity domains (mobility, self-care and interpersonal interactions and relationships) and the mobility component of the participation domain between the weight groups. CONCLUSIONS AND IMPLICATIONS: Obesity has an impact on outcome in lumbar discectomy. Obese patients had higher scores in BDI and ODI indicating mild mood disturbances and moderate functional disability. According to ICF, functional disability of obese patients was observed to some extent in all activity domains. Obese patients will be more frequently present for disc surgery and increased morbidity risk must be recognized. We need a strategy to rehabilitate and activate obese patients pre- and postoperatively.
PURPOSE: To investigate the effect of obesity on outcome in lumbar discectomy. METHODS: A cross-sectional postal survey; a self-made questionnaire, Beck depression inventory IA (BDI IA) and the Oswestry low back disability questionnaire (ODI) were sent to the patients, who had undergone lumbar disc surgery in the Oulu University Hospital between June 2005 and May 2008. Patients were divided into three groups according to BMI: normal, pre-obese and obese. The ODI was also examined in the framework of the international classification of functioning, disability and health (ICF) to investigate its ability to describe various dimensions of functioning (body structure and functions, activities and participation). RESULTS: The postal survey was sent to 642 patients, of whom 355 (55%) replied. Males dominated in the pre-obese (66%) and obese (62%) groups (p=0.01). Normal-weighted and pre-obesepatients had lower BDI scores compared to obesepatients (mean BDI: 8.0, 7.6, 11.2, respectively, p=0.035). Total ODI score was highest in the obese group compared to normal-weighted or pre-obese (20.3, 18.6, 26.4, respectively, p=0.011). When ODI was linked to the ICF there were significant differences in all activity domains (mobility, self-care and interpersonal interactions and relationships) and the mobility component of the participation domain between the weight groups. CONCLUSIONS AND IMPLICATIONS: Obesity has an impact on outcome in lumbar discectomy. Obesepatients had higher scores in BDI and ODI indicating mild mood disturbances and moderate functional disability. According to ICF, functional disability of obesepatients was observed to some extent in all activity domains. Obesepatients will be more frequently present for disc surgery and increased morbidity risk must be recognized. We need a strategy to rehabilitate and activate obesepatients pre- and postoperatively.
Authors: Sara Lener; Christoph Wipplinger; Sebastian Hartmann; Claudius Thomé; Anja Tschugg Journal: Neurosurg Rev Date: 2019-08-14 Impact factor: 3.042