Obesity Negatively Affects Spinal Surgery in Idiopathic Scoliosis

Abstract

Level IV, prognostic study. See Instructions for Authors for a complete description of levels of evidence.

Does Obesity Affect the Surgical Outcome and Complication Rates of Spinal Surgery? A Meta-analysis

“…The reason for more blood loss is presumably the larger corridor to the spine, which causes more tissue trauma. In addition, prolonged operative time may result in increased blood loss [14,32,35]. Length of hospital stay was not a statistical difference between obese and nonobese patients, which is consistent with previous studies [14,27].…”

“…Some studies reported that obesity has been associated with unfavorable surgical outcomes such as longer operative times, greater operative blood loss, and a higher rate of revision for patients having spinal surgery [10,14,31,32,35,39]. However, other studies did not find significant differences regarding surgical outcome and complications between patients who were obese or not obese [2,5,9,26].…”

Patient Factors Are Associated With Poor Short-term Outcomes After Posterior Fusion for Adolescent Idiopathic Scoliosis

“…In our study, the only factor found to be associated with AEs was obesity (BMI-for-age C 95th percentile). Previous studies have had conflicting results regarding increased BMI in patients with AIS [16,45]. Importantly, previous studies used BMI-for-age greater than the eighty-fifth percentile as a clinical cutoff and did not further separate patients with BMI-for-age greater than the ninety-fifth percentile, as was done in our study.…”

“…Such factors are not only important clinically and for setting appropriate patient expectations, but they also are closely tied to total hospital costs associated with the procedure [30]. The information we have on risk factors for AEs in patients undergoing PSF have been derived mainly from studies that either were limited by small sample size [21,41,44,54], only studied one variable [2,16,25,29,31,42,44,45,50,55], included patients with neuromuscular scoliosis and cerebral palsy [5,19,20,24,32,43], used potentially flawed administratively coded or self-reported data [5,7,35,51], or included adult patients with deformity [35].…”

Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review

“…Among adolescents, higher BMIs are protective against the development of scoliosis; however, the cases that do occur tend to be more severe with greater curvature of the spine, 81 curve progression, less successful results with bracing (orthotics), 83 and increased perioperative complications. 84 Scoliosis may be more difficult to assess accurately in children with obesity; the clinician should quantify the degree of curvature with imaging and consider early …”