Obesity has an impact on outcome in lumbar disc surgery

Järvimäki, Voitto; Kautiainen, Hannu; Haanpää, Maija; Alahuhta, Seppo; Vakkala, Merja

doi:10.1016/j.sjpain.2015.10.003

Cited by 8 publications

(3 citation statements)

References 28 publications

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“…In our cohort, obese patients were solely treated surgically [ 9 , 22 ], although higher perioperative risks have been described [ 8 ]. The shorter mean duration of symptoms until treatment starts in obese patients could assume that obese patients are (subjectively) more disabled by symptoms [ 23 ]. Furthermore, pain therapy is challenging, not only due to differences in drug metabolism [ 24 , 25 ] that may consequently lead to earlier and more aggressive treatments.…”

Section: Discussionmentioning

confidence: 99%

The impact of obesity and smoking on young individuals suffering from lumbar disc herniation: a retrospective analysis of 97 cases

et al. 2019

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The negative impact on spinal diseases may apply not only to obesity but also to smoking. To investigate the influence of obesity and smoking on the development and recovery of lumbar disc herniation in young adults. Retrospective analysis of 97 patients who presented with lumbar disc herniation at the authors' department between 2010 and 2017. Data were collected using the patients' digital health records including demographics, clinical and neurological characteristics, treatment details, and outcomes. Ninety-seven patients between 17 and 25 years were included in this retrospective analysis. Patients were categorized into two groups according to their body mass index: obese (O, ≥ 30 kg/m 2 ) and non-obese (NO, < 30 kg/m 2 ). The proportion of obese patients in our cohort vs. in the overall population differed significantly (19.4% vs. 3.8-7.1%, RR 3.17; p < 0.01). Group NO showed a trend toward faster recovery of motor deficits (p = 0.067) and pain (p = 0.074). Also, the proportion of regular smokers differed significantly from the numbers of known smokers of the same age (62.4% vs. 30.2%, RR 2.0; p = 0.01). Obesity plus smoking showed a significantly negative impact on motor deficits postoperatively (p = 0.015) and at discharge (p = 0.025), as well as on pain values (p = 0.037) and on analgesic consumption (p = 0.034) at 6 weeks follow-up. The negative impact of obesity and smoking on the occurrence of lumbar disc herniation could be demonstrated for individuals aged 25 or younger. Furthermore, a trend to earlier recovery of motor deficits and significantly lower pain scales for non-obese and non-smoking patients could be shown.

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Section: Discussionmentioning

confidence: 99%

The impact of obesity and smoking on young individuals suffering from lumbar disc herniation: a retrospective analysis of 97 cases

et al. 2019

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“…Previously identified risk factors include old age, chronicity of symptoms and/ or preoperative inferior mental health, while the importance of body mass index (BMI) has been debated [15]. Obesity, often defined by the World Health Organization (WHO) as body mass index (BMI) ≥ 30 kg/m 2 [16], is usually regarded as a risk factor for inferior outcomes after arthroplasty surgery [17], neurosurgery (23), cardiac surgery (24) and aesthetic surgery [18][19][20], at least partly due to obesity causing other risk factors for comorbidity [21] and anaesthetic complications [22]. Some reports also infer that obesity is a risk factor for inferior outcomes and complications in LDH surgery [23][24][25], while other studies oppose this view [26,27].…”

Section: Introductionmentioning

confidence: 99%

A study comparing outcomes between obese and nonobese patients with lumbar disc herniation undergoing surgery: a study of the Swedish National Quality Registry of 9979 patients

Hareni

Strömqvist

Rosengren

et al. 2022

BMC Musculoskelet Disord

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Background This study aimed to evaluate whether an increasing grade of obesity is associated with inferior outcomes after lumbar disc herniation (LDH) surgery. Methods We retrieved data from the Swedish register for spine surgery regarding patients aged 20–64 who underwent LDH surgery from 2006–2016 and had preoperative and one-year postoperative data. A total of 4156 patients were normal weight, 4063 were overweight, 1384 had class I obesity, 317 had class II obesity and 59 had class III obesity (“morbid obesity”). Data included patient satisfaction, improvement in leg pain (assessed using the National Rating Scale; NRS; rating 0–10), disability (assessed using the Oswestry Disability Index; ODI; rating 0–100) and complications. Results At one year postsurgery, 80% of normal-weight patients, 77% of overweight patients and 74% of obese patients (class I-III evaluated together) were satisfied (p < 0.001) [75%, 71%, 75% in obesity classes I, II, and III, respectively (p = 0.43)]. On average, all groups improved by more than the minimal clinically important difference (MCID) in both NRS leg pain (> 3.5) and ODI (> 20). NRS leg pain improved by 4.8 in normal weight patients (95% CI 4.7–4.9), by 4.5 in overweight patients (4.5–4.6) and by 4.3 in obese patients (4.2–4.4) (p < 0.001) [4.4 (4.3–4.6), 3.8 (3.5–4.1) and 4.6 (3.9–5.3) in obesity classes I, II, and III, respectively (p < 0.001)]. The ODI improved by 30 in normal weight patients (30–31), by 29 in overweight patients (28–29) and by 26 in obese patients (25–27) (p < 0.001) [29 (28–29), 25 (22–27) and 27 (22–32) in obesity classes I, II, and III, respectively (p < 0.01)]. A total of 3.0% of normal-weight patients, 3.9% of overweight patients and 3.9% of obese patients suffered complications (p = 0.047) [3.8%, 4.4%, 3.5% in obesity classes I, II, and III, respectively (p = 0.90)]. Conclusions LDH surgery is also generally associated with favourable outcomes and few complications in patients with morbid obesity.

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“…We have previously reported the outcome of lumbar spine surgery in the Oulu University Hospital (OUH) based on a postal survey targeted at working-aged patients operated between 2005 and 2008. 11 – 13 In this article, we have estimated the incidence of SCS in this cohort and sought factors predicting the use of SCS as a treatment option. We further evaluated a group of patients who predominantly had leg pain (ie, potential candidates for SCS) applying international criteria for SCS.…”

Section: Introductionmentioning

confidence: 99%

Incidence and predictive factors of spinal cord stimulation treatment after lumbar spine surgery

Vakkala¹,

Järvimäki²,

Kautiainen³

et al. 2017

JPR

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IntroductionSpinal cord stimulation (SCS) is recommended for the treatment of postsurgical chronic back and leg pain refractory to other treatments. We wanted to estimate the incidence and predictive factors of SCS treatment in our lumbar surgery cohort.Patients and methodsThree questionnaires (a self-made questionnaire, the Oswestry Low Back Pain Disability Questionnaire, and the Beck Depression Inventory) were sent to patients aged 18–65 years with no contraindications for the use of SCS, and who had undergone non-traumatic lumbar spine surgery in the Oulu University Hospital between June 2005 and May 2008. Patients who had a daily pain intensity of ≥5/10 with predominant radicular component were interviewed by telephone.ResultsAfter exclusions, 814 patients remained in this cohort. Of those, 21 patients had received SCS by the end of June 2015. Fifteen (71%) of these received benefit and continued with the treatment. Complications were rare. The number of patients who replied to the postal survey were 537 (66%). Eleven of them had undergone SCS treatment after their reply. Features predicting SCS implantation were daily or continuous pain, higher intensities of pain with predominant radicular pain, more severe pain-related functional disability, a higher prevalence of depressive symptoms, and reduced benefit from pain medication. The mean waiting time was 65 months (26–93 months). One hundred patients were interviewed by telephone. Fourteen seemed to be potential SCS candidates. From the eleven patients who underwent SCS after responding to the survey, two were classified as potential candidates in the phone interview, while nine were other patients. Twelve patients are still waiting for treatment to commence.ConclusionIn our region, the SCS treatment is used only for very serious pain conditions. Waiting time is too long and it may be the reason why this treatment option is not offered to all candidates.

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Obesity has an impact on outcome in lumbar disc surgery

Abstract: ABSTRACTPurposeTo investigate the effect of obesity on outcome in lumbar discectomy.MethodsA 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… Show more

Cited by 8 publications

References 28 publications

The impact of obesity and smoking on young individuals suffering from lumbar disc herniation: a retrospective analysis of 97 cases

The impact of obesity and smoking on young individuals suffering from lumbar disc herniation: a retrospective analysis of 97 cases

A study comparing outcomes between obese and nonobese patients with lumbar disc herniation undergoing surgery: a study of the Swedish National Quality Registry of 9979 patients

Incidence and predictive factors of spinal cord stimulation treatment after lumbar spine surgery

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