Prior bariatric surgery lowers complication rates following spine surgery in obese patients.

Autor: Passias PG; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA. Peter.Passias@nyumc.org.; Departments of Orthopaedic and Neurological Surgery, New York Spine Institute, NYU Medical Center - Orthopaedic Hospital, 301 East 17th St, New York, NY, 10003, USA. Peter.Passias@nyumc.org., Horn SR; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA., Vasquez-Montes D; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA., Shepard N; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA., Segreto FA; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA., Bortz CA; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA., Poorman GW; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA., Jalai CM; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA., Wang C; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA., Stekas N; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA., Frangella NJ; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA., Deflorimonte C; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA., Diebo BG; Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, NY, USA., Raad M; Department of Neurosurgery, Johns Hopkins Medical Center, Baltimore, MD, USA., Vira S; Department of Orthopaedic Surgery, NYU Langone Medical Center-Orthopaedic Hospital, New York, NY, USA., Horowitz JA; Department of Orthopaedic Surgery, University of Virginia Medical Center, Charlottesville, VA, USA., Sciubba DM; Department of Neurosurgery, Johns Hopkins Medical Center, Baltimore, MD, USA., Hassanzadeh H; Department of Orthopaedic Surgery, University of Virginia Medical Center, Charlottesville, VA, USA., Lafage R; Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, NY, USA., Afthinos J; Staten Island University Hospital, Staten Island, NY, USA., Lafage V; Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, NY, USA.
Jazyk: angličtina
Zdroj: Acta neurochirurgica [Acta Neurochir (Wien)] 2018 Dec; Vol. 160 (12), pp. 2459-2465. Date of Electronic Publication: 2018 Nov 08.
DOI: 10.1007/s00701-018-3722-6
Abstrakt: Background: Bariatric surgery (BS) is an increasingly common treatment for morbid obesity that has the potential to effect bone and mineral metabolism. The effect of prior BS on spine surgery outcomes has not been well established. The aim of this study was to assess differences in complication rates following spinal surgery for patients with and without a history of BS.
Methods: Retrospective analysis of the prospectively collected New York State Inpatient Database (NYSID) years 2004-2013. BS patients and morbidly obese patients (non-BS) were divided into cervical and thoracolumbar surgical groups and propensity score matched for age, gender, and invasiveness and complications compared.
Results: One thousand nine hundred thirty-nine spine surgery patients with a history of BS were compared to 1625 non-BS spine surgery patients. The average time from bariatric surgery to spine surgery is 2.95 years. After propensity score matching, 740 BS patients were compared to 740 non-BS patients undergoing thoracolumbar surgery, with similar comorbidity rates. The overall complication rate for BS thoracolumbar patients was lower than non-BS (45.8% vs 58.1%, P < 0.001), with lower rates of device-related (6.1% vs 23.2%, P < 0.001), DVT (1.2% vs 2.7%, P = 0.039), and hematomas (1.5% vs 4.5%, P < 0.001). Neurologic complications were similar between BS patients and non-BS patients (2.3% vs 2.7%, P = 0.62). For patients undergoing cervical spine surgery, BS patients experienced lower rates of bowel issues, device-related, and overall complication than non-BS patients (P < 0.05).
Conclusions: Bariatric surgery patients undergoing spine surgery experience lower overall complication rates than morbidly obese patients. This study warrants further investigation into these populations to mitigate risks associated with spine surgery for bariatric patients.
Databáze: MEDLINE
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