26. Impact of obesity on nonfusion risk following anterior cervical discectomy and fusion

IF 2.5 Q3 Medicine

North American Spine Society Journal Pub Date : 2025-07-01 DOI:10.1016/j.xnsj.2025.100720

Yu Chang MD , Shih-Huang Tai PhD , Yu-Ning Chen MD , E-Jian Lee MD, PhD

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Abstract

BACKGROUND CONTEXT

Anterior cervical discectomy and fusion (ACDF) is a widely performed surgical procedure to treat cervical disc herniation, leading to myelopathy and radiculopathy. The procedure involves removing the affected disc and fusing the vertebrae to restore stability and relieve symptoms. Obesity is a growing concern in the surgical population and has been associated with various postoperative complications. Previous studies suggest that obesity may impact postoperative outcome following spinal surgeries. This study aims to explore how obesity, as measured by BMI, affects fusion rates in patients undergoing single-level ACDF.

PURPOSE

N/A

STUDY DESIGN/SETTING

This cohort study utilized the TriNetX network database, spanning from 2008 to 2023, to identify patients who underwent single-level ACDF.

PATIENT SAMPLE

Patients undergoing single-level ACDF were included.

OUTCOME MEASURES

The primary outcome was the incidence of nonfusion, identified by the International Classification of Disease-10 code M96.0, within 6 months to 2 years postoperatively.

METHODS

Patients were categorized based on their BMI into two groups: BMI < 30 and BMI = 30. Propensity score matching (PSM) performed based on patient characteristic and comorbidities.

RESULTS

Following 1:1 propensity score matching, the final cohorts comprised 12,733 patients in each group, with balanced demographics and comorbidities between the two groups. At 6 months postoperatively, 15.27% of patients with BMI < 30 (1,827 nonfusions in 11,965 patients) experienced nonfusion, compared to 14.07% of patients with BMI = 30 (1,690 non-fusions in 12,012 patients), with an odds ratio (OR) of 1.101 (95% CI: 1.025–1.182). At 1 year postoperatively, 17.73% of patients with BMI < 30 (1,957 nonfusions in 11,041 patients) experienced nonfusion, compared to 16.24% of patients with BMI = 30 (1,800 nonfusions in 11,082 patients), with an OR of 1.111 (95% CI: 1.036–1.192). At 2 years postoperatively, the nonfusion rate was 17.64% for patients with BMI < 30 (2,058 nonfusions in 11,669 patients) and 16.39% for patients with BMI = 30 (1,920 nonfusions in 11,712 patients), with an OR of 1.092 (95% CI: 1.02–1.169).

CONCLUSIONS

This study found a significant association between obesity (BMI = 30) and an increased risk of non-fusion following single-level ACDF surgery. The elevated risk was observed at 6 months, 1 year, and 2 years postoperatively, indicating that obesity negatively impacts the likelihood of successful fusion after surgery.

FDA Device/Drug Status

This abstract does not discuss or include any applicable devices or drugs.

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26. 肥胖对颈前路椎间盘切除术和融合术后不融合风险的影响

背景：前路颈椎间盘切除术和融合术（ACDF）是一种广泛应用于治疗颈椎间盘突出症的手术方法，可导致脊髓病和神经根病。手术过程包括移除受影响的椎间盘并融合椎骨以恢复稳定性并缓解症状。肥胖是手术人群日益关注的问题，并与各种术后并发症有关。先前的研究表明，肥胖可能会影响脊柱手术后的预后。本研究旨在探讨BMI测量的肥胖如何影响单节段ACDF患者的融合率。目的/研究设计/背景本队列研究利用TriNetX网络数据库，时间跨度为2008年至2023年，以确定接受单级ACDF的患者。患者样本接受单水平ACDF的患者被纳入。主要终点是术后6个月至2年内不融合的发生率，由国际疾病分类（International Classification of Disease-10 code M96.0）确定。方法根据BMI指数将患者分为BMI组和BMI组；30和BMI = 。倾向评分匹配（PSM）基于患者特征和合并症进行。结果按照1:1的倾向评分匹配，最终的队列包括每组12,733名患者，两组之间的人口统计学和合并症平衡。术后6个月，15.27%的患者BMI <；30例（11965例患者中有1,827例未融合）未融合，而BMI为14.07%的患者 = 30（12,012例患者中有1,690例未融合），优势比（OR）为1.101 （95% CI: 1.025-1.182）。术后1年，17.73%的患者BMI <；30例（11,041例患者中1,957例未融合）未融合，而BMI为16.24%的患者 = 30（11,082例患者中1,800例未融合），OR为1.111 （95% CI: 1.036-1.192）。术后2年，BMI和lt患者的不融合率为17.64%；BMI为 = = 30（11,712例患者中1,920例未融合），OR为1.092 （95% CI: 1.02-1.169）。结论：本研究发现肥胖（BMI = 30）与单节段ACDF手术后不融合风险增加之间存在显著关联。在术后6个月、1年和2年观察到风险升高，表明肥胖对术后成功融合的可能性有负面影响。FDA器械/药物状态本摘要不讨论或包括任何适用的器械或药物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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