An age and sex matched study on the effect of obesity on the functional outcomes and complication rates in patients with adult spinal deformity undergoing primary multi-level thoracolumbar spinal fusion.

Autor:	Kieser DC; Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch School of Medicine, Christchurch, New Zealand., Wyatt MC; Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch School of Medicine, Christchurch, New Zealand., Boissiere L; L'Institut de la Colonne Vertébrale, CHU Pellegrin, Bordeaux, France., Hayashi K; L'Institut de la Colonne Vertébrale, CHU Pellegrin, Bordeaux, France., Cawley DT; L'Institut de la Colonne Vertébrale, CHU Pellegrin, Bordeaux, France., Yilgor C; Acibadem University School of Medicine, Istanbul, Turkey., Larrieu D; L'Institut de la Colonne Vertébrale, Bordeaux University Hospital, Place Amélie Raba-Léon, Bordeaux, France., Alanay A; Acibadem University School of Medicine, Istanbul, Turkey., Acaroglu E; Spine Surgery Unit, Ankara Acibadem ARTES Spine Center, Ankara, Turkey., Kleinstueck F; Spine Center, Schulthess Klinik, Zurich, Switzerland., Pellisé F; Spine Surgery Unit, Hospital Universitario Val Hebron, Barcelona, Spain., Perez-Grueso FJS; Spine Surgery Unit, Hospital Universitario La Paz, Madrid, Spain., Bourghli A; Orthopedic and Spinal Surgery Department, Kingdom Hospital, Riyadh, Saudi Arabia., Vital JM; L'Institut de la Colonne Vertébrale, CHU Pellegrin, Bordeaux, France., Gille O; L'Institut de la Colonne Vertébrale, CHU Pellegrin, Bordeaux, France., Obeid I; L'Institut de la Colonne Vertébrale, CHU Pellegrin, Bordeaux, France.
Jazyk:	angličtina
Zdroj:	Annals of joint [Ann Jt] 2022 Oct 15; Vol. 7, pp. 33. Date of Electronic Publication: 2022 Oct 15 (Print Publication: 2022).
DOI:	10.21037/aoj-22-14
Abstrakt:	Background: The objective of this study was to determine the effect of obesity on the functional outcomes and complication rates of patients with adult spinal deformity (ASD) undergoing multi-level thoracolumbar fusion. Methods: An age and sex matched comparison of functional outcomes [Numeric Rating Scale (NRS) back and leg scores, Core Outcome Measurement Index (COMI) back scores, Scoliosis Research Society 22 (SRS22) satisfaction and total scores, Short Form 36 (SF36) general health scores, Physical Component Score (PCS), Mental Component Score (MCS), Oswestry Disability Index (ODI) (including all domains)] at 6 months, 1, 2, 3 and 4 years and the complication rates at final follow-up between obese [body mass index (BMI) >30] and normal BMI (18.5-24.9) patients undergoing more than 3 levels of thoracolumbar fusion with a minimum 2-year follow-up. Patients who had undergone any previous spinal surgery were excluded. Results: Thirty patients were included in each arm of the study. Baseline demographics, including the number of levels fused, were similar between the groups. Estimated blood loss (EBL) was higher in obese patients (1,916 vs. 1,099 mL, P=0.001), but operative time was similar (282 vs. 320 min, P=0.351). The functional outcomes and satisfaction scores were consistently poorer in the obese group at all time-points, but their satisfaction scores were similar. Obese patients had a higher complication rate (OR 3.05, P=0.038) predominantly due to dural tears and nerve root injuries, but a similar reoperation rate. Conclusions: In patients with ASD undergoing multi-level thoracolumbar fusion, obesity results in a higher blood loss, poorer sagittal correction, poorer post-operative functional scores and higher complication rates than patients with a normal BMI. However, obesity does not affect operative times, length of hospital stay or reoperation rates. Furthermore, patients with obesity have similar post-operative satisfaction scores to patients with normal BMIs. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://aoj.amegroups.com/article/view/10.21037/aoj-22-14/coif). The authors have no conflicts of interest to declare. (2022 Annals of Joint. All rights reserved.)
Databáze:	MEDLINE
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