Weight change patterns following surgery for cervical spondylosis in overweight and obese individuals: a nationwide longitudinal study.

Abstract

Introduction: Cervical spondylosis may cause pain and disability, which leads to reduced activity levels and subsequent weight gains in affected patients. Surgical treatment of cervical spondylosis has been shown to improve quality of life and restore physical activity levels.

Objective: We hence hypothesized that surgery in obese and overweight patients may lead to significant weight loss by means of pain and disability reduction as well as restoration of physical activity. This study aims to investigate whether surgery for cervical spondylosis leads to postoperative weight changes in overweight and obese patients.

Methods: This is a retrospective longitudinal cohort study using prospective data. Obese and overweight patients who underwent surgery for cervical spondylosis in Sweden from 2005 to 2020, using the Swedish National Spine Register (SweSpine). Weight and BMI at both 1- and 2-years postoperatively were included in the analysis. Significant postoperative weight loss was considered as a loss of ≥ 5% of the initial preoperative weight and was the primary outcome of the study.

Results: Of the 4,231 patients included in the main analysis, 32% were obese and 68% overweight. At 1-year follow-up, 25% of obese and 15% of overweight patients showed significant weight loss (≥ 5%, average 7 kg), increasing to 28% and 19% respectively by 2 years (p < 0.001). Younger patients (< 60 years) were more likely to lose significant weight at 1 year compared to older patients (20% vs. 16%, p = 0.005). Predictors of significant weight loss included obesity (OR: 1.87), NDI (OR: 1.01), NRS arm pain score (OR: 1.03), and NRS neck pain score (OR: 1.03), while male sex was linked to a lower likelihood of weight loss (OR: 0.74).

Discussion: In conclusion, this study indicates that cervical spondylosis surgery may be associated with significant weight loss, particularly in younger and obese patients. Other predictors included higher preoperative pain and disability levels and female sex. Nonetheless, significant weight loss only occurred in a minority of patients. Future research should investigate the impact of a multidisciplinary approach on weight management and further examine additional predictive factors influencing weight loss.