肥胖患者减肥手术前后腰痛、残疾和矢状位排列的比较研究

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-09-29 DOI:10.1016/j.clineuro.2025.109175

Mohammad Daher , Alice Boishardy , Maud Monsaingeon-Henry , Ibrahim Obeid , Olivier Gille , Amer Sebaaly , Blandine Gatta-Cherifi , Louis Boissiere

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引用次数: 0

摘要

研究设计：对前瞻性收集的数据进行回顾性分析。目的：本研究比较了一组肥胖患者BS前后的腰痛、患者报告的结果测量（PROMs）和矢状位对齐。背景：许多研究表明，减肥手术（BS）对改善腰痛和减少残疾有积极的影响。然而，没有研究描述BS前后的整体矢状面平衡。方法：对41例肥胖患者进行单中心随访，随访1年。提取的数据包括基线人口统计学和特征、背部和腿部疼痛的数值评定量表（NRS）、PROMs （SF12短表评分、Oswestry残疾指数（ODI）评分和魁北克评分）和放射学参数。结果：接受BS治疗的患者在术后1年体重和BMI均有显著下降。此外，腰痛患者的数量显著减少（66% % vs 17% %,p ）。结论：本研究表明BS可显著减轻肥胖患者的腰痛并改善其功能，使其成为患有背痛的病态肥胖患者脊柱手术的令人信服的替代方案。它还支持将超重与椎间盘退变联系起来的力学理论。

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Low back pain, disability and sagittal alignment of obese patients before and after bariatric surgery: A comparative study

Study design

Retrospective analysis of prospectively collected data.

Objective

This study compared low back pain, patient-reported outcome measures (PROMs), and sagittal alignment in a cohort of obese patients before and after BS.

Background

Many studies suggest that bariatric surgery (BS) has a positive impact on improving low back pain and decreasing disability. However, there are no studies describing global sagittal balance before and after BS.

Methods

A cohort of 41 obese patients with1 year follow up after BS in a single center. The extracted data consisted of baseline demographics and characteristics, Numerical Rating Scale (NRS) for back and leg pain, PROMs (Short Form 12 (SF12) score, Oswestry Disability Index (ODI) scores and Quebec score), and radiographic parameters.

Results

Patients undergoing BS had a significant reduction in weight, and BMI at 1 year post-operatively. In addition, there was a significant reduction in the number of patients having back pain (66 % vs 17 %, p < .001). In fact, the back and leg NRS scores improved significantly 1 year post-operatively (3.8 ± 2.6 vs 1.2 ± 1.9, p < .001; 3.8 ± 2.0 vs 3.0 ± 1.4, p < .001, respectively) as did both ODI and PCS-SF12. As for radiographic parameters, there was a decrease in sacral slope (39.0 ± 10.0 vs 36.9 ± 9.0, p < 0.05) alongside the number of vertebras in lumbar lordosis (7.4 ± 1.5 vs 7.0 ± 1.2, p < 0.01), and an increase in quebe the mean disc-height of both L4-L5 (0.28 ± 0.06 vs 0.32 ± 0.06, p < 0.01) and L5-S1 (0.26 ± 0.07 vs 0.30 ± 0.08, p < 0.01).

Conclusion

This study demonstrates that BS significantly reduces low back pain and improves function in obese patients, making it a compelling alternative to spinal surgery in morbidly obese patients suffering from back pain. It also supports the mechanical theory linking excess weight to disc-degeneration.

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.