Peter G Passias1, Gregory W Poorman2, Samantha R Horn2, Cyrus M Jalai2, Cole Bortz2, Frank Segreto2, Bassel M Diebo3, Alan Daniels4, D Kojo Hamilton5, Daniel Sciubba6, Justin Smith7, Brian Neuman8, Christopher I Shaffrey7, Virginie LaFage9, Renaud LaFage9, Frank Schwab9, Shay Bess10, Christopher Ames11, Robert Hart12, Alexandra Soroceanu13, Gregory Mundis14, Robert Eastlack15. 1. Department of Orthopedics, NYU Langone Orthopedic Hospital, New York, New York, USA. Electronic address: Peter.Passias@nyumc.org. 2. Department of Orthopedics, NYU Langone Orthopedic Hospital, New York, New York, USA. 3. Deparment of Orthopedic Surgery, SUNY Downstate Medical School, Brooklyn, New York, USA. 4. Department of Orthopedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA. 5. Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. 6. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 7. Department of Neurosurgery, University of Virginia Medical Center, Charlottesville, Virginia, USA. 8. Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 9. Department of Orthopedics, Hospital for Special Surgery, New York, New York, USA. 10. Rocky Mountain Scoliosis and Spine, Denver, Colorado, USA. 11. Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California, USA. 12. Department of Orthopaedic Surgery, Swedish Neuroscience Institute, Seattle, Washington, USA. 13. Department of Orthopaedic Surgery, University of Calgary, Calgary, Alberta, Canada. 14. San Diego Center for Spinal Disorders, La Jolla, California, USA. 15. Division of Orthopaedic Surgery, Scripps Clinic, La Jolla, California, USA.
Abstract
OBJECTIVE: We investigated the 30-day complication incidence and 1-year radiographic correction in obese patients undergoing surgical treatment of cervical deformity. METHODS: The patients were stratified according to World Health Organization's definition for obesity: obese, patients with a body mass index of ≥30 kg/m2; and nonobese, patients with a body mass index of <30 kg/m2. The patients had undergone surgery for the treatment of cervical deformity. The patient baseline demographic, comorbidity, and radiographic data were compared between the 2 groups at baseline and 1 year postoperatively. The 30-day complication incidence was stratified according to complication severity (any, major, or minor), and type (cardiopulmonary, dysphagia, infection, neurological, and operative). Binary logistic regression models were used to assess the effect of obesity on developing those complications, with adjustment for patient age and levels fused. RESULTS: A total of 124 patients were included, 53 obese and 71 nonobese patients. The 2 groups had a similar T1 slope minus cervical lordosis (obese, 37.2° vs. nonobese, 36.9°; P = 0.932) and a similar C2-C7 (-5.9° vs. -7.3°; P = 0.718) and C2-C7 (50.1 mm vs. 44.1 mm; P = 0.184) sagittal vertical axis. At the 1-year follow-up examination, the T1 pelvic angle (1.0° vs. -3.1°; P = 0.021) and C2-S1 sagittal vertical axis (-5.9 mm vs. -35.0 mm; P = 0.036) were different, and the T1 spinopelvic inclination (-1.0° vs. -2.9°; P = 0.123) was similar. The obese patients had a greater risk of overall short-term complications (odds ratio, 2.5; 95% confidence interval, 1.1-6.1) and infectious complications (odds ratio, 5.0; 95% confidence interval, 1.0-25.6). CONCLUSIONS: Obese patients had a 5 times greater odds of developing infections after surgery for adult cervical deformity. Obese patients also showed significantly greater pelvic anteversion after cervical correction.
OBJECTIVE: We investigated the 30-day complication incidence and 1-year radiographic correction in obesepatients undergoing surgical treatment of cervical deformity. METHODS: The patients were stratified according to World Health Organization's definition for obesity: obese, patients with a body mass index of ≥30 kg/m2; and nonobese, patients with a body mass index of <30 kg/m2. The patients had undergone surgery for the treatment of cervical deformity. The patient baseline demographic, comorbidity, and radiographic data were compared between the 2 groups at baseline and 1 year postoperatively. The 30-day complication incidence was stratified according to complication severity (any, major, or minor), and type (cardiopulmonary, dysphagia, infection, neurological, and operative). Binary logistic regression models were used to assess the effect of obesity on developing those complications, with adjustment for patient age and levels fused. RESULTS: A total of 124 patients were included, 53 obese and 71 nonobese patients. The 2 groups had a similar T1 slope minus cervical lordosis (obese, 37.2° vs. nonobese, 36.9°; P = 0.932) and a similar C2-C7 (-5.9° vs. -7.3°; P = 0.718) and C2-C7 (50.1 mm vs. 44.1 mm; P = 0.184) sagittal vertical axis. At the 1-year follow-up examination, the T1 pelvic angle (1.0° vs. -3.1°; P = 0.021) and C2-S1 sagittal vertical axis (-5.9 mm vs. -35.0 mm; P = 0.036) were different, and the T1 spinopelvic inclination (-1.0° vs. -2.9°; P = 0.123) was similar. The obesepatients had a greater risk of overall short-term complications (odds ratio, 2.5; 95% confidence interval, 1.1-6.1) and infectious complications (odds ratio, 5.0; 95% confidence interval, 1.0-25.6). CONCLUSIONS:Obesepatients had a 5 times greater odds of developing infections after surgery for adult cervical deformity. Obesepatients also showed significantly greater pelvic anteversion after cervical correction.
Authors: Katherine E Pierce; Peter Gust Passias; Avery E Brown; Cole A Bortz; Haddy Alas; Renaud Lafage; Oscar Krol; Dean Chou; Douglas C Burton; Breton Line; Eric Klineberg; Robert Hart; Jeffrey Gum; Alan Daniels; Kojo Hamilton; Shay Bess; Themistocles Protopsaltis; Christopher Shaffrey; Frank A Schwab; Justin S Smith; Virginie Lafage; Christopher Ames Journal: J Craniovertebr Junction Spine Date: 2021-09-08