The Effect of High Obesity on Outcomes of Treatment for Lumbar Spinal Conditions (original) (raw)

Study Design/Setting-SPORT subgroup analysis Objective-To evaluate the effect of extreme obesity on management of lumbar spinal stenosis (SpS), degenerative spondylolisthesis (DS), and intervertebral disc herniation (IDH) Summary of Background Data-Prior SPORT analyses compared nonobese and obese. This study compares nonobese to class I obesity and class II/III extreme obesity. Methods-For SpS, 250/634 nonobese, 104/167 obese, and 59/94 extremely obese patients underwent surgery. For DS, 233/376 nonobese, 90/129 obese, and 66/96 extremely obese patients had surgery. For IDH, 542/854 nonobese, 151/207 obese, 94/129 extremely obese patients had surgery. Outcomes included SF-36, Oswestry Disability Index, Stenosis/Sciatica Bothersomeness Index, Low Back Pain Bothersomeness Index, operative events, complications, and reoperations. Results-Extremely obese patients had increased comorbidities. Baseline SF-36 physical function scores were lower for obese; lowest for extremely obese. For SpS, surgical treatment effect and operative events among groups were not significantly different. For DS, 4-year SF-36 physical function scores had greatest treatment effect in extremely obese. This observation was found in most primary outcome measures, and is attributable to the significantly poorer nonoperative outcomes. Operative times and wound infection rates were greatest for the extremely obese. Additional surgery at 3 and 4 years was higher in both obese cohorts.