Influence of Obesity on Outcomes of Surgery for Lumbar Spinal Canal Stenosis

Abstract

Background: Obesity is likewise becoming more prevalent in patients with lumbar spinal canal stenosis, but few studies have examined relationships between obesity levels and surgical outcomes for this condition. The purpose of the present study is to determine the influence of body-mass index (BMI) on outcomes of surgery for lumbar spinal canal stenosis. Materials and Methods: The subjects comprised 118 patients who had underwent posterolateral fusion in a single intervertebral disc space with spinal instrumentation using a pedicle screw and rod system. Obesity levels were classified into three groups according to BMI: 35, severely obese group (n=12); 25 to <35, obese (n=38); and <25, non-obese (n=68). Investigated items including operative time, volume of intraoperative bleeding, distance from skin surface to the posterior margin of the vertebral body, improvement rate of the Japanese Orthopaedic Association (JOA) scoring system for lumbar spinal disorders and intra-and postoperative complications were all compared between the three groups. Results: Longer operative time, increased intraoperative bleeding, longer distance from the skin surface to the posterior margin of the vertebral body, poor postoperative outcomes and higher incidences of intra-and postoperative complications were observed with surgery for lumbar spinal canal stenosis in severely obese patients (BMI 35), compared to patients with BMI <35. Conclusions: Severely obese patients and their family members should thus receive sufficient explanation of the risks associated with surgery when obtaining informed consent.

Surgical and Clinical Results of Minimally Invasive Spinal Fusion Surgery in an Unselected Patient Cohort of a Spinal Care Unit

“…As expected, the duration of surgery was strongly related to the number of spinal levels treated. In contrast to a previous report by Furukawa et al ., a prolonged duration of surgery was not seen among obese patients in our population. The length of surgery was further influenced by patient age, with older patients having increased durations of surgery, probably attributable to their general co‐morbidities affecting the surgical procedure as such.…”

“…In contrast, Furukawa et al . (2010) reported poor postoperative outcomes of MIS in severely obese patients and a higher risk of perioperative complications.…”

“…Whereas complex multi‐level spinal surgeries or open surgeries were observed to carry higher complication risks in elderly patients, this did not hold true among elderly patients undergoing MIS. In view of these findings, it is reasonable to assume that MIS provides a promising and innovative alternative for elderly patients, but also for patients with significant co‐morbidities, and other risk factors, such as obesity and active smoking status. The number of obese patients is increasing due to changed lifestyles, and body mass index impacts surgical outcomes.…”

“…The number of obese patients is increasing due to changed lifestyles, and body mass index impacts surgical outcomes. Besides worse postoperative outcomes, higher risks of perioperative complications were reported for severely obese patients. Another highly prevalent risk factor for several medical conditions is cigarette smoking, which negatively affects the musculoskeletal system.…”

Obesity is associated with poorer range of motion and Tegner scores following hamstring autograft anterior cruciate ligament reconstruction in Asians

“…The current literature reporting on the impact of BMI on outcomes of orthopaedic surgical procedures is varied and inconsistent. Some studies report an increased complication rate and length of hospital stay after surgery in obese patients (3,4) while others have not found any increased risk of surgery or postoperative complications (5,6). Most studies comparing the outcomes of orthopaedic surgery in obese patients were conducted in patients following hip or knee arthroplasty (4,6).…”