Does Obesity Make an Influence on Surgical Outcomes Following Lumbar Microdiscectomy?

Abstract

ObjectiveThe purpose of this study was to evaluate the effect of patients' bod mass index (BMI) on surgical outcomes following one-level lumbar microdiscectomy.MethodsFrom June 2003 to March 2007, 129 patients underwent one-level lumbar microdiscectomy performed at a single institution. We divided the patients into 3 groups, depending on BMI. A retrospective study was conducted among the 3 groups. The operation time, estimated blood loss (EBL), postoperative hospital day, recurrent disc herniation, intraoperative durotomy, and postoperative epidural steroid injection were analyzed. Regression models were used to predict the relationship between BMI and surgical outcomes including operation time and EBL.ResultsAs BMI is greater, as the operation time is longer and the EBL is more. In particular, linear regression model analysis implied that 2.35 minute in the operation time is longer and 8.89cc in EBL is more, as BMI of 1 kg/m2 is increased. No statistically relevant differences were observed for postoperative hospital day, recurrent disc herniation, intraoperative durotomy, and postoperative epidural steroid injection.ConclusionThe operation time and EBL was significantly increased in obesity, but there were no differences in surgical outcomes. Our results demonstrated that higher BMI are not likely to encounter heightened morbidity in lumbar microdiscectomy.

Obesity and Chronic Pain

“…169 One Korean study showed that obesity did not affect surgical outcomes following lumbar microdiscectomy. 170 In at least 1 study, investigators suggested this may be due to patient noncompliance. 31 These studies highlight a need for a better understanding of the available treatment options and the development of new approaches to the simultaneous treatment of obesity and pain, such as with pharmacologic options.…”

Surgical Outcome of Fusion in Recurrent Lumbar Disc Herniation

“…Reherniated lumbar is an important disease which seen commonly. The rate of recurrent disc herniation after lumbar discectomy is 5% to 15% [5]. So that, recurrent lumbar disc herniation (RLDH) is a major cause of surgical failure [7], the recurrent disc herniation is the major cause of the failed back surgery syndrome [8].…”

“…Some surgeons choose simple discectomy again, while some surgeons advocate fusion surgery. Because recurrent disectomy (ipsilateral/contralateral) requires more disc and posterior spinal component removal (lamina and/or facet joint), recurrent discectomy will increase the likelihood of segmental instability and due to scar tissue; dural tear, and nerve injuries may be greater at simple re-discectomies, some surgeons suggest fusion surgery at first recurrent, regardless of whether instability [5].…”

Failed back surgery syndrome

“…Отношение к ожирению как фактору риска рецидива ГМД неоднозначно: по некоторым данным, ожирениезначимый фактор риска рецидива, однако по другимнет [10][11][12]. Выполнение кюретажа диска в дополнение к секвестрэктомии снижает риск рецидива ГМД на 3%.…”