Obese (Body Mass Index >30) Patients Have Greater Functional Improvement and Reach Equivalent Outcomes at 12 Months Following Decompression Surgery for Symptomatic Lumbar Stenosis.

Abstract:

OBJECTIVE:To evaluate effect of obesity on 12-month functional outcomes after surgery for lumbar stenosis in adult patients. METHODS:Data were collected on patients treated with lumbar laminectomy for symptomatic lumbar spinal stenosis as part of an observational registry and analyzed using a retrospective cohort study design. Patients with body mass index (BMI) >30 were compared with patients with BMI <30 with respect to baseline, 3-month, and 12-month functional status, adjusted for potential confounders. RESULTS:There were 101 patients. At baseline, patients with BMI >30 had significantly more back pain (P < 0.001), more leg pain (P < 0.001), lower EuroQol 5 dimensions questionnaire (EQ-5D) scores (P < 0.001), and higher Oswestry Disability Index (ODI) scores (P < 0.001). Both low- and high-BMI groups had significant improvement in back pain, leg pain, EQ-5D scores, and ODI scores after decompression (all P < 0.001). At 3 months postoperatively, high-BMI patients continued to report greater leg pain (P = 0.063) and higher ODI score (P = 0.064) relative to low-BMI patients. By 12 months, there was no difference between low- and high-BMI patients in back pain (P = 0.929), leg pain (P = 0.638), EQ-5D score (P = 0.733), or ODI score (P = 0.214). CONCLUSIONS:The difference between low- and high-BMI patients trended toward significance for leg pain and ODI score at 3 months, but this difference disappeared by 12 months. This suggests that obese patients with symptomatic lumbar spinal stenosis may require longer to recover after decompression but can expect to reach equivalent outcomes of similarly treated patients with BMI <30.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Elsayed G,Davis MC,Dupépé EC,McClugage SG,Szerlip P,Walters BC,Hadley MN

doi

10.1016/j.wneu.2017.06.072

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

884-894

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(17)30964-6

journal_volume

105

pub_type

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