Outcome of non-instrumented lumbar spinal surgery in obese patients: a systematic review

Ghobrial, Julian B.; Gadjradj, Pravesh S.; Harhangi, Biswadjiet S.; Dammers, Rúben; Vleggeert-Lankamp, Carmen L. A.

doi:10.1080/02688697.2021.1885615

Cited by 4 publications

(3 citation statements)

References 36 publications

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“…A recent systematic review supports the view of obese patients having no inferior outcomes to patients with lower BMI, when summarizing that obese patients have similar postoperative outcomes to non-obese patients after non-instrumented lumbar surgery (19). However, this review used a BMI cut-off value 30 when comparing patients, without evaluating the outcomes in each obesity class separately.…”

Section: Discussionmentioning

confidence: 99%

“…Obesity (BMI ≥ 30.0 ( 9 )) is associated with inferior outcomes in a variety of surgical procedures ( 10 - 12 ), and in spine surgery with infection, venous thromboembolism, perioperative blood loss, and prolonged surgical time ( 13 , 14 ). Some studies report inferior clinical outcome also in obese spine-surgical patients ( 15 , 16 ), while others oppose this ( 7 , 17 - 19 ).…”

mentioning

confidence: 99%

“…NRS leg pain improved in normal-weight patients by 3.5 (95% CI 3.4-3.6), overweight by 3.2 (CI 3.1-3.2), and obese by 2.6 (CI 2.5-2.7), and 2.8 (CI 2.7-2.9), 2.5 (CI 2.2-2.7), and 2.6 (CI 2.0-3.2) in obese classes I-III, respectively. ODI improved in normal weight by [19][20], overweight by 17 (CI [17][18], and obese by 14 (CI 13-15), and 16 (CI 15-17), 14 (CI 13-16), 14 in obese classes I-III, respectively. 8.1% of normal weight, 7.0% of overweight, and 8.1% of obese patients suffered complications (p = 0.04) and 8.1%, 7.0%, and 17% among obese classes I-III, respectively (p < 0.01).…”

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confidence: 99%

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A comparison study on patient-reported outcome between obese and non-obese patients with central lumbar spinal stenosis undergoing surgical decompression: 14,984 patients in the National Swedish Quality Registry for Spine Surgery

Hareni

Gudlaugsson

Strömqvist

et al. 2022

ActaO

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Background and purpose: Obesity has been associated with inferior outcomes after laminectomy due to central lumbar spinal stenosis (CLSS); we evaluated whether this occurs in surgery on national bases.Patients and methods: We retrieved pre- and 1-year postoperative data from the National Swedish Quality Registry for Spine Surgery regarding patients aged ≥ 50 with laminectomy due to CLSS in 2005–2018. 4,069 patients had normal weight, 7,044 were overweight, 3,377 had class I obesity, 577 class II obesity, and 94 class III obesity (“morbid obesity”). Patient-reported outcome included satisfaction after 1 year, leg pain (Numerical Rating Scale [NRS], rating 0–10), disability (Oswestry Disability Index [ODI], rating 0–100). Complications were also retrieved.Results: 1-year postoperatively, 69% of patient of normal weight, 67% who were overweight, and 62% with obesity (classes I–III aggregated) were satisfied (p < 0.001) and 62%, 60%, and 57% in obese groups I–III, respectively (p = 0.7). NRS leg pain improved in normal-weight patients by 3.5 (95% CI 3.4–3.6), overweight by 3.2 (CI 3.1–3.2), and obese by 2.6 (CI 2.5–2.7), and 2.8 (CI 2.7–2.9), 2.5 (CI 2.2–2.7), and 2.6 (CI 2.0–3.2) in obese classes I–III, respectively. ODI improved in normal weight by 19 (CI 19–20), overweight by 17 (CI 17–18), and obese by 14 (CI 13–15), and 16 (CI 15–17), 14 (CI 13–16), 14 (CI 11–18) in obese classes I–III, respectively. 8.1% of normal weight, 7.0% of overweight, and 8.1% of obese patients suffered complications (p = 0.04) and 8.1%, 7.0%, and 17% among obese classes I–III, respectively (p < 0.01).Conclusion: Most obese patients are satisfied after laminectomy due to CLSS, even if satisfaction rate is inferior compared with normal-weight patients. The morbidly obese have more complications than patients with lower BMI.

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Section: Discussionmentioning

confidence: 99%