Impact of Body Mass Index on Postsurgical Outcomes for Workers' Compensation Patients Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion.

Autor:	Patel MR; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA., Jacob KC; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA., Chavez FA; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA., DesLaurier JT; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA., Pawlowski H; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA., Prabhu MC; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA., Vanjani NN; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA., Singh K; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA kern.singh@rushortho.com.
Jazyk:	angličtina
Zdroj:	International journal of spine surgery [Int J Spine Surg] 2022 Jun 20. Date of Electronic Publication: 2022 Jun 20.
DOI:	10.14444/8309
Abstrakt:	Background: Increased morbidity associated with obesity imposes a greater financial burden on companies that provide insurance to their employees. Few studies have investigated the relationship between body mass index (BMI) and patient-reported outcome measures (PROMs) for minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) in the workers' compensation (WC) population. Methods: WC patients who underwent a primary, single-level MIS TLIF were included/grouped according to BMI: nonobese (<30 kg/m 2 ); obese I (≥30, <35 kg/m 2 ); severe + morbid (≥35). PROMs were collected pre- and postoperatively: visual analog scale (VAS), Oswestry Disability Index (ODI), 12-Item Short Form (SF-12) physical composite score (PCS), and Patient-Reported Outcome Measurement Information System physical function (PROMIS-PF). BMI predictive power grouping on PROMs was evaluated using simple linear regression. Established minimum clinically important difference values were used to compute achievement rates across PROMs using logistic regression. Results: A total of 116 nonobese, 70 obese I, and 61 severe + morbid patients were included. Demographics among BMI grouping significantly differed in gender, hypertensive status, and American Society of Anesthesiologists score ( P ≤ 0.037, all). Operative time was significantly different in perioperative values among BMI grouping ( P ≤ 0.001). Increased BMI was significantly associated with greater VAS back at 12 weeks and 2 years ( P ≤ 0.026, all), greater ODI preoperatively at 12 weeks and 6 months ( P ≤ 0.015, all), and decreased PROMIS-PF at 12 weeks ( P ≤ 0.011, all). Mean PROMs between obese I and severe + morbid cohorts differed in SF-12 PCS at 12 weeks, only ( P = 0.050). ODI overall was the only parameter for which minimum clinically important difference was achieved among BMI cohorts ( P ≤ 0.023). Conclusion: WC patients with increased BMI were more likely to develop significant back pain and disability at numerous postoperative timepoints compared with nonobese individuals. Our findings highlight the weight management importance within WC population to minimize back pain and disability following MIS TLIF, but provide a sense of reassurance with comparable clinical improvement regardless of BMI. Clinical Relevance: When considering the effect of weight, surgeons may incorporate these findings in managing patient expectations in the WC population undergoing lumbar spine surgery. Competing Interests: Declaration of Conflicting Interests: The authors report no conflicts of interest in this work. (This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2022 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.)
Databáze:	MEDLINE
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