{"title":"腰椎融合手术后肥胖与假关节风险的关系","authors":"Yu Chang, Kuan-Yu Chi, Junmin Song, Hong-Min Lin, Chien-Min Chen","doi":"10.1016/j.spinee.2025.03.031","DOIUrl":null,"url":null,"abstract":"<p><strong>Background context: </strong>Obesity is a known risk factor for various adverse health conditions and surgical complications, including in spine surgery. While obesity is associated with increased perioperative risks in lumbar fusion surgery, its impact on long-term fusion success remains controversial.</p><p><strong>Purpose: </strong>To evaluate the effect of obesity on fusion outcomes following posterior lumbar fusion surgery, with a specific focus on the incidence of pseudarthrosis at multiple postoperative time points.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Patient sample: </strong>Patients were identified through the TriNetX Global Collaborative Network using ICD-10-PCS and CPT codes specific to lumbar fusion procedures. After propensity score matching for demographic and comorbidity variables, 41,436 obese patients (BMI ≥ 30 kg/m<sup>2</sup>) were compared with 41,436 non-obese patients (BMI < 30 kg/m<sup>2</sup>).</p><p><strong>Outcome measures: </strong>The primary outcome was the incidence of pseudarthrosis, identified using ICD-10 code M96.0 at 6 months, 1 year, and 2 years postoperatively.</p><p><strong>Methods: </strong>Propensity score matching (PSM) was applied to minimize confounding. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the risk of pseudarthrosis between obese and non-obese groups.</p><p><strong>Results: </strong>The incidence of pseudarthrosis was consistently lower in the obese cohort across all postoperative time points. At 6 months postoperatively, the incidence was 9.2% in obese patients compared to 11.8% in non-obese patients (OR: 0.75, 95% CI: 0.72-0.79). At 1 year, pseudarthrosis occurred in 10.4% of obese patients versus 13.0% in non-obese patients (OR: 0.78, 95% CI: 0.74-0.81). At 2 years, rates were 11.6% in the obese group and 14.1% in the non-obese group (OR: 0.80, 95% CI: 0.76-0.83). These findings indicate a consistent and statistically significant association between obesity and lower odds of pseudarthrosis following lumbar spine fusion surgery.</p><p><strong>Conclusions: </strong>Despite higher perioperative complication rates typically associated with obesity, our study found that obese patients experienced significantly lower rates of pseudarthrosis following lumbar spine fusion surgery.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9000,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association between obesity and pseuarthrosis risk following lumbar fusion surgery.\",\"authors\":\"Yu Chang, Kuan-Yu Chi, Junmin Song, Hong-Min Lin, Chien-Min Chen\",\"doi\":\"10.1016/j.spinee.2025.03.031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background context: </strong>Obesity is a known risk factor for various adverse health conditions and surgical complications, including in spine surgery. While obesity is associated with increased perioperative risks in lumbar fusion surgery, its impact on long-term fusion success remains controversial.</p><p><strong>Purpose: </strong>To evaluate the effect of obesity on fusion outcomes following posterior lumbar fusion surgery, with a specific focus on the incidence of pseudarthrosis at multiple postoperative time points.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Patient sample: </strong>Patients were identified through the TriNetX Global Collaborative Network using ICD-10-PCS and CPT codes specific to lumbar fusion procedures. After propensity score matching for demographic and comorbidity variables, 41,436 obese patients (BMI ≥ 30 kg/m<sup>2</sup>) were compared with 41,436 non-obese patients (BMI < 30 kg/m<sup>2</sup>).</p><p><strong>Outcome measures: </strong>The primary outcome was the incidence of pseudarthrosis, identified using ICD-10 code M96.0 at 6 months, 1 year, and 2 years postoperatively.</p><p><strong>Methods: </strong>Propensity score matching (PSM) was applied to minimize confounding. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the risk of pseudarthrosis between obese and non-obese groups.</p><p><strong>Results: </strong>The incidence of pseudarthrosis was consistently lower in the obese cohort across all postoperative time points. At 6 months postoperatively, the incidence was 9.2% in obese patients compared to 11.8% in non-obese patients (OR: 0.75, 95% CI: 0.72-0.79). At 1 year, pseudarthrosis occurred in 10.4% of obese patients versus 13.0% in non-obese patients (OR: 0.78, 95% CI: 0.74-0.81). At 2 years, rates were 11.6% in the obese group and 14.1% in the non-obese group (OR: 0.80, 95% CI: 0.76-0.83). These findings indicate a consistent and statistically significant association between obesity and lower odds of pseudarthrosis following lumbar spine fusion surgery.</p><p><strong>Conclusions: </strong>Despite higher perioperative complication rates typically associated with obesity, our study found that obese patients experienced significantly lower rates of pseudarthrosis following lumbar spine fusion surgery.</p>\",\"PeriodicalId\":49484,\"journal\":{\"name\":\"Spine Journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2025-03-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.spinee.2025.03.031\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.spinee.2025.03.031","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Association between obesity and pseuarthrosis risk following lumbar fusion surgery.
Background context: Obesity is a known risk factor for various adverse health conditions and surgical complications, including in spine surgery. While obesity is associated with increased perioperative risks in lumbar fusion surgery, its impact on long-term fusion success remains controversial.
Purpose: To evaluate the effect of obesity on fusion outcomes following posterior lumbar fusion surgery, with a specific focus on the incidence of pseudarthrosis at multiple postoperative time points.
Study design: Retrospective cohort study.
Patient sample: Patients were identified through the TriNetX Global Collaborative Network using ICD-10-PCS and CPT codes specific to lumbar fusion procedures. After propensity score matching for demographic and comorbidity variables, 41,436 obese patients (BMI ≥ 30 kg/m2) were compared with 41,436 non-obese patients (BMI < 30 kg/m2).
Outcome measures: The primary outcome was the incidence of pseudarthrosis, identified using ICD-10 code M96.0 at 6 months, 1 year, and 2 years postoperatively.
Methods: Propensity score matching (PSM) was applied to minimize confounding. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the risk of pseudarthrosis between obese and non-obese groups.
Results: The incidence of pseudarthrosis was consistently lower in the obese cohort across all postoperative time points. At 6 months postoperatively, the incidence was 9.2% in obese patients compared to 11.8% in non-obese patients (OR: 0.75, 95% CI: 0.72-0.79). At 1 year, pseudarthrosis occurred in 10.4% of obese patients versus 13.0% in non-obese patients (OR: 0.78, 95% CI: 0.74-0.81). At 2 years, rates were 11.6% in the obese group and 14.1% in the non-obese group (OR: 0.80, 95% CI: 0.76-0.83). These findings indicate a consistent and statistically significant association between obesity and lower odds of pseudarthrosis following lumbar spine fusion surgery.
Conclusions: Despite higher perioperative complication rates typically associated with obesity, our study found that obese patients experienced significantly lower rates of pseudarthrosis following lumbar spine fusion surgery.
期刊介绍：
The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.
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