Impact of obesity on outcomes following lumbar spine surgery: A systematic review and meta-analysis

Goyal, Anshit; Elminawy, Mohamed; Kerezoudis, Panagiotis; Lu, Victor M.; Yolcu, Yagiz U.; Alvi, Mohammed Ali; Bydon, Mohamad

doi:10.1016/j.clineuro.2018.12.012

Cited by 74 publications

(67 citation statements)

References 42 publications

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“…In the postoperative period, there is an increased risk of impaired wound healing due to low regional perfusion and oxygen tension, infectious complications and last but not least, worsened and limited rehabilitation after surgical procedure (7,8,11,12). From the perspective of spine surgery, if a patient after surgery does not follow an adequate regular rehabilitation and suffi cient physical activity, obesity of the patient leads to a higher risk for recurrence of degenerative spine diffi culties requiring revision surgery.…”

Section: Discussionmentioning

confidence: 99%

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Is obesity a significant risk factor of symptomatic spinal epidural hematoma after elective degenerative lumbar spine surgery?

Snopko¹,

Opšenák²,

Hanko³

et al. 2021

BLL

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INTRODUCTION: The occurrence of symptomatic spinal epidural hematoma after spine surgery is a rare, but serious major complication whose incidence usually requires urgent surgical intervention. Obesity is currently considered to be one of the most common metabolic diseases. METHODS: Prospective analysis of patients who underwent surgical treatment of degenerative lumbar spine disease from January 2016 to February 2018 with one-year follow-up. All patients underwent decompression of spinal cord and nerve roots. This study was conducted to determine an association between the incidence of spinal epidural hematoma (SEDH) requiring surgical treatment and obesity/body mass index (BMI). RESULTS: In our study, data from 371 patients were assessed. SEDH requiring surgical intervention occurred totally in seven patients (1.89 %). An average BMI in patients with presence of SEDH was 30.67 kg/m 2 . Our work showed a statistically signifi cant difference between BMI in patients with SEDH compared to patients without SEDH (p = 0.0044). This study also showed a signifi cant difference in incidence of symptomatic SEDH in obese patients compared to non-obese patients (p = 0.0158). CONCLUSION: In our study, we found out that obesity is a signifi cant risk factor for the incidence of postoperative SEDH after degenerative lumbar spine surgery (Tab. 1, Fig. 2, Ref. 18).

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Section: Discussionmentioning

confidence: 99%

“…It is scientifi cally proven that obesity signifi cantly increases morbidity and mortality and last but not least, worsens the quality of life. Obesity can negatively affect the course of surgical procedures due to the development of perioperative and postoperative complications (7,8).…”

Section: Introductionmentioning

confidence: 99%

Is obesity a significant risk factor of symptomatic spinal epidural hematoma after elective degenerative lumbar spine surgery?

Snopko¹,

Opšenák²,

Hanko³

et al. 2021

BLL

View full text Add to dashboard Cite

show abstract

“…al found that obese patients were fourteen times more likely to have longer operative times compared to non-obese patients 10 . Goyal et al examined 14 studies with over 6,000 patients and found that obesity is associated with significantly higher operative times, both for MIS procedures and open spine surgeries 31 . Our findings are consistent with the literature in that obese patients in class II-III had significantly longer operative times.…”

Section: Discussionmentioning

confidence: 99%

Impact of body mass index on opioid consumption in lumbar spine fusion surgery

LeRoy

Moon

Gedman

et al. 2021

North American Spine Society Journal (NASSJ)

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Therefore, increased BMI is strongly correlated with both knee osteoarthritis (KOA) and hand osteoarthritis, whereas several studies have found no association between BMI and hip osteoarthritis (HOA) [12]. In addition, obese patients are considered less favorable surgical candidates for decompression surgery in degenerative lumbar spinal canal stenosis (LCS) and lower limb arthroplasty including hip and knee joint [2, 15–17]. Some reasons include increased surgical time, longer length of hospital stay and more postoperative complications for obese patients, compared to patients with normal weight.…”

Section: Introductionmentioning

confidence: 99%

Effect of body mass index on surgical times of lumbar laminoplasty and lower limb arthroplasties

Harato

Yagi

Fujita

et al. 2019

BMC Musculoskelet Disord

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Background Obesity is an important factor affecting incidence and development of musculoskeletal degenerative changes. In addition, obese patients are considered less favorable surgical candidates for decompression surgery in degenerative lumbar spinal canal stenosis and lower limb arthroplasty. The purpose was to assess disease characteristics of lumbar spinal canal stenosis as well as lower limb osteoarthritis, and to investigate surgical times based on body mass index (BMI) in lumbar decompressive surgery and lower limb arthroplasties. Methods A total of 1161 patients with a diagnosis of lumbar canal stenosis (LCS), hip osteoarthritis (HOA) and knee osteoarthritis (KOA) were enrolled. The present investigation was conducted as a retrospective study using routinely collected data. All patients underwent primary decompressive surgery (laminoplasty: LAM) or lower limb arthroplasty (total hip arthroplasty: THA and total knee arthroplasty: TKA). All of the patients were divided into 3 groups based on BMI (kg/m 2 ) (Group A: ≤ 24.9; Group B: 25–29.9; Group C: ≥ 30) within each disease category. To assess disease characteristics, age, gender, and BMI were evaluated for each disease category. Moreover, surgical times for LAM, THA and TKA were also assessed based on BMI classification. Results A total of 269, 470, and 422 patients were allocated to the HOA category, the KOA category, and the LCS category, respectively. The KOA category included the oldest patients and largest BMI, compared to the HOA and the LCS categories. Regarding gender difference, LCS was more common in males than in females, while opposite phenomenon was observed in the HOA and the KOA categories. The heaviest group (Group C) was significantly younger than Groups A or B in TKA and LAM. Surgical time was significantly longer in patients with overweight or obese patients than in those with normal weight in TKA and LAM, while BMI didn’t affect the time in THA. Conclusions Disease characteristics of the KOA category and the LCS category were notably affected by BMI, and surgical times in TKA and LAM were significantly longer for overweight or obese patients, whereas THA was less affected by BMI concerning disease characteristics and surgical time.

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Impact of obesity on outcomes following lumbar spine surgery: A systematic review and meta-analysis

Cited by 74 publications

References 42 publications

Is obesity a significant risk factor of symptomatic spinal epidural hematoma after elective degenerative lumbar spine surgery?

Is obesity a significant risk factor of symptomatic spinal epidural hematoma after elective degenerative lumbar spine surgery?

Impact of body mass index on opioid consumption in lumbar spine fusion surgery

Effect of body mass index on surgical times of lumbar laminoplasty and lower limb arthroplasties

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