Spine Surgery Outcomes Measurably worse in Obese Patients
Posted Jan 11 2013 7:57am
Obese patients are more likely to have back problems requiring surgery, the surgery is also made more complex, takes longer and there are poorer outcomes.
A new research study published in the January 2013 Journal of Bone and Joint Surgery (JBJS) compared non-obese patients to obese patients requiring back surgery. The types of surgical treatments required are normally for lumbarThe part of the back between the lowest ribs and the top of the pelvis. disc herniationAn abnormal protrusion (sticking out) of tissue (slipped or ruptured discs). The study found that obesityExcess accumulation of fat in the body. increases operative time, bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. loss and length of hospital stay. Overall, obese patients had poorer outcomes with surgical and nonsurgical treatments for lumbar disc herniation than non-obese patients.
Jeffrey Rihn, MD, associate professor at Thomas Jefferson University Hospital and The Rothman Institute said, "The findings suggest that obese patients with symptomatic lumbar disc herniation do not do as well as non-obese patients with nonsurgical or surgical treatment”.
Obese patients did not have an increased rate of infectionInvasion by organisms that may be harmful, for example bacteria or parasites., intraoperative complications, recurrent disc herniation or reoperation.
Obese patients had significantly less improvement in the Sciatica Bothersomeness Index and Low Back Pain Bothersomeness Index, but reported no significant difference in self-rated overall improvement/satisfaction.
The benefit of surgery over nonoperative treatment was not affected by body mass indexA measure of whether a person’s weight is normal, too high or too low. It is calculated by dividing their weight in kilograms by the square of their height in metres..
Recurrence of disc herniation and need for additional surgical procedures did not differ significantly between obese and nonobese patients. This finding contradicts previous studies on this topic.
"The results of this study may be helpful in educating patients about their treatment options and expected outcomes," said Dr. Rihn. "These findings may suggest that weight loss should be encouraged in patients with this condition. However, this study does not specifically address whether weight loss in obese patients would affect their clinical outcome with nonsurgical or surgical treatment."