Wolfgang Senker1, Harald Stefanits1, Matthias Gmeiner1, Wolfgang Trutschnig2, Ingo Weinfurter3, Andreas Gruber4. 1. Department of Neurosurgery, Kepler University Hospital, Neuromed Campus, Linz, Austria. 2. Department of Mathematics, University of Salzburg, Salzburg, Austria. 3. Department of Trauma Surgery and Sports Traumatology, Kepler University Hospital, Linz, Austria. 4. Department of Neurosurgery, Kepler University Hospital, Neuromed Campus, Linz, Austria. Electronic address: andreas.gruber_1@kepleruniklinikum.at.
Abstract
OBJECTIVE: The impact of obesity on spine surgery has been studied extensively, but only a few investigations have been focused on minimally invasive spinal fusion techniques and complication rates in normal-weight, preobese, or obese patients. Obesity was found to be a risk factor for intraoperative complications. Published data tend to favor minimal access surgery techniques (MAST) for obese patients. In a prospective study, we assessed the perioperative and postoperative complications of MAST in a large population of 187 patients. METHODS: We evaluated perioperative and postoperative complication rates in minimally invasive surgery (MIS) fusion techniques of the lumbar spine in obese, preobese, and normal-weight patients, classified by body mass index (BMI). Lumbar MIS fusion was performed by interbody fusion procedures and posterolateral fusion. In cases of spinal stenosis, a laminotomy was performed (146 patients). Any harmful event occurring during or after surgery was included in the statistical analysis. RESULTS: No infection or severe wound healing disorder was encountered in the series. No significant difference in terms of cerebrospinal fluid leakage, blood loss, drainage, or length of hospital stay between the 3 BMI groups was encountered. More clinically insignificant hematomas were encountered in the preobese and obese groups (P = 0.013) than in the normal-weight patients. No significant difference was registered between the BMI or age groups regarding overall complication rates. CONCLUSION: We conclude that preobese and obese patients are good candidates for MAST because BMI did not affect complication rates or duration of surgery.
OBJECTIVE: The impact of obesity on spine surgery has been studied extensively, but only a few investigations have been focused on minimally invasive spinal fusion techniques and complication rates in normal-weight, preobese, or obesepatients. Obesity was found to be a risk factor for intraoperative complications. Published data tend to favor minimal access surgery techniques (MAST) for obesepatients. In a prospective study, we assessed the perioperative and postoperative complications of MAST in a large population of 187 patients. METHODS: We evaluated perioperative and postoperative complication rates in minimally invasive surgery (MIS) fusion techniques of the lumbar spine in obese, preobese, and normal-weight patients, classified by body mass index (BMI). Lumbar MIS fusion was performed by interbody fusion procedures and posterolateral fusion. In cases of spinal stenosis, a laminotomy was performed (146 patients). Any harmful event occurring during or after surgery was included in the statistical analysis. RESULTS: No infection or severe wound healing disorder was encountered in the series. No significant difference in terms of cerebrospinal fluid leakage, blood loss, drainage, or length of hospital stay between the 3 BMI groups was encountered. More clinically insignificant hematomas were encountered in the preobese and obese groups (P = 0.013) than in the normal-weight patients. No significant difference was registered between the BMI or age groups regarding overall complication rates. CONCLUSION: We conclude that preobese and obesepatients are good candidates for MAST because BMI did not affect complication rates or duration of surgery.
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: 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