A Comparative Cohort Study of Lumbar Microdiscectomy in Obese and Nonobese Patients.

Abstract

Study design: Prospective comparative cohort study.

Objective: Investigate whether there is a difference in postoperative pain reduction, complication rate, and other markers of operative difficulty in obese and nonobese patients undergoing elective lumbar microdiscectomy by a single spinal surgeon.

Summary of background data: Lumbar radiculopathy is a debilitating condition that affects obese and nonobese patients. There is reluctance among some surgeons to perform lumbar microdiscectomy in the obese population.

Methods: Over 3 years a group of 34 obese patients were compared with 34 nonobese patients from the same period. Operative duration, blood loss, unintentional durotomies, infection rate, hospital stay, and pain reduction were compared.

Results: Reduction in total pain (control, -82%; obese, -71%) and radicular leg pain (control, -98%; obese, -97%) were similar. The risk of superficial infections was greater in the obese group, but there was no difference in rate of serious complication in our small series. Operative duration was much longer in the obese group (control, 28 min; obese, 70 min), as was total hospital stay.

Conclusions: We found good postoperative pain relief in both groups. There was no difference in radicular leg pain between obese and nonobese patients but total pain due to lumbago was greater preoperatively and postoperatively in the obese group making their total pain greater. There was no evidence of higher serious complication rate that would preclude offering operative lumbar microdiscectomy to obese patients due to their obesity alone. However, operative duration was significantly longer in obese patients and should be considered accordingly.