Lumbar Microdiscectomy in Obese Patients: A Multicenter Observational Study.

Autor: Madsbu MA; Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. Electronic address: mattis.madsbu@gmail.com., Øie LR; Department of Neurology, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway., Salvesen Ø; Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway., Vangen-Lønne V; Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway., Nygaard ØP; Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; National Advisory Unit on Spinal Surgery, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; The Norwegian National Registry for Spine Surgery, University Hospital of Northern Norway (UNN), Tromsø, Norway., Solberg TK; The Norwegian National Registry for Spine Surgery, University Hospital of Northern Norway (UNN), Tromsø, Norway; Department of Neurosurgery, University Hospital of Northern Norway (UNN), Tromsø, Norway., Gulati S; Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; National Advisory Unit on Spinal Surgery, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2018 Feb; Vol. 110, pp. e1004-e1010. Date of Electronic Publication: 2017 Dec 06.
DOI: 10.1016/j.wneu.2017.11.156
Abstrakt: Objective: To evaluate the association between obesity and outcomes after microdiscectomy for lumbar disc herniation.
Methods: The primary outcome measure was change in Oswestry Disability Index (ODI) at 1 year after surgery. Obesity was defined as body mass index (BMI) ≥30. Prospective data were retrieved from the Norwegian Registry for Spine Surgery.
Results: We enrolled 4932 patients, 4018 nonobese and 914 obese. For patients with complete 1-year follow-up (n = 3381) the mean improvement in ODI was 31.2 points (95% confidence interval 30.4-31.9, P < 0.001). Improvement in ODI was 31.4 points in nonobese and 30.1 points in obese patients (P = 0.182). Obese and nonobese patients were as likely to achieve a minimal clinically important difference (84.2 vs. 82.7%, P = 0.336) in ODI (≥10 points improvement). Obesity was identified as a negative predictor for ODI improvement in a multiple regression analysis (BMI 30-34.99; P < 0.001, BMI ≥35; P = 0.029). Obese and nonobese patients experienced similar improvement in Euro-Qol-5 scores (0.48 vs. 0.49 points, P = 0.441) as well as back pain (3.7 vs. 3.5 points, P = 0.167) and leg pain (4.7 vs. 4.8 points, P = 0.654), as measured by the Numeric Rating Scale. Duration of surgery was shorter for nonobese patients (55.7 vs. 65.3 minutes, P ≤ 0.001). Nonobese patients experienced fewer complications compared with obese patients (6.1% vs. 8.3%, P = 0.017). Obese patients had slightly longer hospital stays (2.0 vs. 1.8 days, P = 0.004).
Conclusions: Although they had more minor complications, obese individuals experienced improvement after lumbar microdiscectomy for lumbar disc herniation similar to that of nonobese individuals.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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