Obesity and posterior spinal fat content: impact on complications in non-complex lumbar spine surgery

Grover, Patrick; Pushpananthan, Suresh; Samarage, Hasitha M; Mendoza, Nigel

doi:10.1080/02688697.2016.1220502

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…Single-center retrospective studies with smaller cohorts have found similar results 28,29,32–34 . Grover et al 35 found that obesity and posterior spinal fat content positively correlate with LOS. Using Marketscan data, our study adds to the growing body of data that patients with obesity experience a higher incidence of postoperative complications (Table 2) and increased LOS, revision rate, and readmission rate (Table 3).…”

Section: Discussionmentioning

confidence: 72%

Obesity in Patients Undergoing Lumbar Degenerative Surgery—A Retrospective Cohort Study of Postoperative Outcomes

Varshneya

Wadhwa

Stienen

et al. 2021

Spine

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Study Design. Retrospective cohort studying using a national, administrative database. Objective. The aim of this study was to determine the postoperative complications and quality outcomes of patients with and without obesity undergoing surgical management for lumbar degenerative disease (LDD). Summary of Background Data. Obesity is a global epidemic that negatively impacts health outcomes. Characterizing the effect of obesity on LDD surgery is important given the growing elderly obese population. Methods. This study identified patients with who underwent surgery for LDD between 2007 and 2016. Patients were stratified based on whether the patient had a concurrent diagnosis of obesity at time of surgery. Propensity score matching (PSM) was then utilized to mitigate intergroup differences between patients with and without obesity. Patients who underwent three or more levels surgical correction, were under the age of 18 years, or those with any previous history of trauma or tumor were excluded from this study. Baseline comorbidities, postoperative complication rates, and reoperation rates were determined. Results. A total of 67,215 patients underwent primary lumbar degenerative surgery, of which 22,405 (33%) were obese. After propensity score matching, baseline covariates of the two cohorts were similar. The complication rate was 8.3% in the nonobese cohort and 10.4% in the obese cohort (P < 0.0001). Patients with obesity also had longer lengths of stay (2.7 days vs. 2.4 days, P < 0.05), and higher rates of reoperation and readmission at all time-points through the study follow-up period to their nonobese counterparts (P < 0.05). Including payments after discharge, lumbar degenerative surgery in patients with obesity was associated with higher payments throughout the 2-year follow-up period ($68,061 vs. $59,068 P < 0.05). Conclusion. Patients with a diagnosis of obesity at time of LDD surgery are at a higher risk for postoperative complications, reoperation, and readmission.

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Section: Discussionmentioning

confidence: 72%

Obesity in Patients Undergoing Lumbar Degenerative Surgery—A Retrospective Cohort Study of Postoperative Outcomes

Varshneya

Wadhwa

Stienen

et al. 2021

Spine

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“…Specifically, 729 papers were duplicated, while 732 articles were found to have irrelevant title. Moreover, 45 articles were excluded after reading since they did not meet the inclusion 124 Retrospective study 2 Kukreja et al, 2015 51 Retrospective study 2 Lingutla et al, 2015 30 Meta-analysis 1 Nota SP et al, 2015 125 Retrospective study 2 Ou et al, 2015 10 Retrospective study 2 Planchard RF et al, 2015 126 Retrospective study 2 Retrospective study 2 96 Mcclendon et al, 2014 16 Retrospective study 2 97 McGuire KJ et al, 2014 132 Prospective study 1 98 Pereira BJ et al, 2014 133 Retrospective study 2 99 Quah C et al, 2014 134 Retrospective study 2 100 Seicean A et al, 2014 135 Retrospective cohort study 3 101 Srinivasan et al, 2014 136 Retrospective study 2 102 Terman et al, 2014 28 Retrospective cohort study 3 103 Wang J et al, 2014 137 Prospective study 1 104 Lau, Khan et al, 2013 27 Retrospective study 2 105 Lau, Ziewacz et al, 2013 52 Retrospective study 2 106 Rihn JA et al, 2013 138 Retrospective study 2 107 Rosenfeld HE et al, 2013 139 Case series 4 108 Gaudelli C et al, 2012 140 Retrospective cohort study 3 109 Kalanithi et al, 2012 17 Retrospective study 2 110 Mehta AI et al, 2012 141 Retrospective study 2 111…”

Section: Resultsmentioning

confidence: 99%

“…While outcomes are reported to be satisfactory and often comparable among obese and nonobese patients treated with surgery when needed, peri-operative complications rate seems to be higher in most of the analyzed papers with few exceptions ( Table 3 ). 60 , 62 , 63 , 65 , 66 , 70 , 73 , 77 , 78 , 80 , 82 , 86 , 88 , 90 , 92 - 94 , 97 , 101 , 102 , 105 , 107 , 109 - 112 , 114 , 116 , 118 , 123 , 125 , 126 , 129 , 131 , 133 , 135 , 139 - 141 , 146 - 148 , 151 - 153 , 166 -...…”

Section: Discussionmentioning

confidence: 99%

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Obesity and Spine Surgery: A Qualitative Review About Outcomes and Complications. Is It Time for New Perspectives on Future Researches?

Cofano

Perna

Bongiovanni

et al. 2021

Global Spine Journal

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Study Design: Literature review. Objectives: An increasing number of obese patients requires operative care for degenerative spinal disorders. The aim of this review is to analyze the available evidence regarding the role of obesity on outcomes after spine surgery. Peri-operative complications and clinical results are evaluated for both cervical and lumbar surgery. Furthermore, the contribution of MIS techniques for lumbar surgery to play a role in reducing risks has been analyzed. Methods: Only articles published in English in the last 10 years were reviewed. Inclusion criteria of the references were based on the scope of this review, according to PRISMA guidelines. Moreover, only paper analyzing obesity-related complications in spine surgery have been selected and thoroughly reviewed. Each article was classified according to its rating of evidence using the Sacket Grading System. Results: A total number of 1636 articles were found, but only 130 of them were considered to be relevant after thorough evaluation and according to PRISMA checklist. The majority of the included papers were classified according to the Sacket Grading System as Level 2 (Retrospective Studies). Conclusion: Evidence suggest that obese patients could benefit from spine surgery and outcomes be satisfactory. A higher rate of peri-operative complications is reported among obese patients, especially in posterior approaches. The use of MIS techniques plays a key role in order to reduce surgical risks. Further studies should evaluate the role of multidisciplinary counseling between spine surgeons, nutritionists and bariatric surgeons, in order to plan proper weight loss before elective spine surgery.

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Impact of Obesity on Complications and 30-Day Readmission Rates After Cranial Surgery: A Single-Institutional Study of 224 Consecutive Craniotomy/Craniectomy Procedures

2017

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Obesity and posterior spinal fat content: impact on complications in non-complex lumbar spine surgery

Cited by 5 publications

References 22 publications

Obesity in Patients Undergoing Lumbar Degenerative Surgery—A Retrospective Cohort Study of Postoperative Outcomes

Obesity in Patients Undergoing Lumbar Degenerative Surgery—A Retrospective Cohort Study of Postoperative Outcomes

Obesity and Spine Surgery: A Qualitative Review About Outcomes and Complications. Is It Time for New Perspectives on Future Researches?

Impact of Obesity on Complications and 30-Day Readmission Rates After Cranial Surgery: A Single-Institutional Study of 224 Consecutive Craniotomy/Craniectomy Procedures

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