Comparison of Complications and Clinical and Radiographic Outcomes Between Nonobese and Obese Patients with Adult Spinal Deformity Undergoing Minimally Invasive Surgery

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• 作者：Paul Park¹ ; ^{ppark@umich.edu" class="auth_mail" title="E-mail the corresponding author} ; Michael Y. Wang² ; Stacie Nguyen³ ; Gregory M. Mundis Jr.³ ; Frank La Marca¹ ; Juan S. Uribe⁴ ; Neel Anand⁵ ; David O. Okonkwo⁶ ; Adam S. Kanter⁶ ; Richard Fessler⁷ ; Robert K. Eastlack⁸ ; Dean Chou⁹ ; Vedat Deviren¹⁰ ; Pierce D. Nunley¹¹ ; Christopher I. Shaffrey¹² ; Praveen V. Mummaneni⁹ ; on behalf of the International Spine Study Group
• 关键词：Complications ; Minimally invasive surgery ; Obesity ; Outcomes ; Scoliosis ; Spinal deformity
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：87
• 期：Complete
• 页码：55-60
• 全文大小：3105 K

文摘

Obesity can be associated with increased complications and potentially worse outcomes. We aimed to evaluate the impact of obesity on complications and outcomes in patients with adult spinal deformity (ASD) who underwent minimally invasive surgery (MIS).

<h4 id="absSec_2">Methodsh4>

A multicenter database of patients with ASD treated via MIS was queried. Of 190 patients in the database, 77 fit the inclusion criteria of 3 or more spinal levels treated minimally invasively. Patients were divided by body mass index (BMI) <30 (nonobese; n = 59) and BMI ≥30 (obese; n = 18).

<h4 id="absSec_3">Resultsh4>

Mean BMI was 24.6 nonobese and 35.0 obese (P < 0.001). There were mean 3.8 interbody fusions nonobese and 4.7 obese (P = 0.065). Levels treated posteriorly averaged 5.8 nonobese and 5.9 obese (P = 0.502). Mean follow-up was 34.4 months nonobese and 35.3 months obese (P = 0.976). Baseline radiographic parameters were similar between groups. Postoperatively, SVA averaged 83.9 mm obese and 20.4 mm nonobese (P = 0.002). Postoperative lumbar lordosis-pelvic incidence mismatch averaged 17.9° obese and 9.9° nonobese (P = 0.028). Both groups had improvement in Oswestry Disability Index (ODI) scores with no difference in postoperative ODI scores between groups (P = 0.090). Similarly, both groups had decreased VAS scores for back and leg pain with no difference between groups postoperatively. Twenty (33.9%) nonobese patients versus 7 (38.9%) obese patients had complications (P = 0.452).

<h4 id="absSec_4">Conclusionsh4>

Our results suggest that obesity does not negatively impact complication rate or clinical outcomes in patients with ASD treated via MIS approaches.