Nicholas B Pohl, Jonathan Dalton, Rachel Huang, Rajkishen Narayanan, Omar H Tarawneh, Yunsoo Lee, Harrison Fellheimer, Maximilliano Buckner, Mark F Kurd, Ian David Kaye, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler
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引用次数: 0
Abstract
Purpose: This study investigated the association between preoperative body mass index and surgical outcomes, reoperation rate, and one-year patient-reported outcome measures (PROMs) following 1-3 level revision lumbar fusion.
Methods: Patients who underwent a 1-3 level revision lumbar fusion from 2011-2021 were included. Patients were grouped into BMI classes: Normal (18.5-24.99), Overweight (25.0-29.99), Obese Class 1 (30.0-34.99), Obese Class 2+ (≥35.0). Demographics, surgical characteristics, one-year reoperations, 90-day readmissions, and one-year PROMs were compared between cohorts. PROMs included the Short Form-12 Physical Component Score, Mental Component Score, Oswestry Disability Index, Visual Analog Scale (VAS) Back pain score, and VAS Leg pain score.
Results: In total, 743 patients were identified - 115 Normal Weight, 254 Overweight, 206 Obese Class 1, and 168 Obese Class 2+. Operative time (p=0.007) and length of stay (LOS) (p=0.002) were longer in patients with higher BMI. Multivariate regression demonstrated Obese Class 2+ was independently associated with longer operative times (Estimate: 32.43; p=0.008) and LOS (Estimate: 0.68; p=0.044). There were no differences in readmission (p=0.285) or reoperation rates (p=0.727). All patients received a similar benefit between preoperative and 1-year PROMs.
Conclusions: While more obese revision lumbar fusion patients experienced longer operative times and LOS, these patients ultimately experienced similar improvements from surgical intervention at one year postoperatively. Regardless of BMI class, all patients had comparable rates of readmission within 90 days and reoperation. These findings support previous lumbar fusion literature and suggest an indicated revision lumbar fusion in higher BMI class patients does not lead to further reoperations or worse PROMs.
期刊介绍：
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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