Comparison of Complications and Clinical and Radiographic Outcomes Between Non-Obese and Obese Patients With Adult Spinal Deformity Undergoing Minimally Invasive Surgery

Publication date: Available online 25 December 2015
Source:World Neurosurgery
Author(s): Paul Park, Michael Y. Wang, Stacie Nguyen, Gregory M. Mundis, Frank La Marca, Juan S. Uribe, Neel Anand, David O. Okonkwo, Adam S. Kanter, Richard Fessler, Robert K. Eastlack, Dean Chou, Vedat Deviren, Pierce D. Nunley, Christopher I. Shaffrey, Praveen V. Mummaneni
ObjectiveObesity can be associated with increased complications and potentially worse outcomes. We aimed to evaluate the impact of obesity on complications and outcomes in patients with adult spinal deformity (ASD) who underwent minimally invasive surgery (MIS).MethodsMulticenter database of patients with ASD treated via MIS was queried. Of 190 patients in the database, 77 fit the inclusion criteria of 3 or more spinal levels treated minimally invasively. Patients were divided by body mass index (BMI) < 30 (non-obese; n = 59), and BMI ≥ 30 (obese; n = 18).ResultsMean BMI was 24.6 non-obese, and 35.0 obese (p < 0.001). There were mean 3.8 interbody fusions non-obese, and 4.7 obese (p = 0.065). Levels treated posteriorly averaged 5.8 non-obese, and 5.9 obese (p = 0.502). Mean follow-up was 34.4 months non-obese, and 35.3 months obese (p = 0.976). Baseline radiographic parameters were similar between groups. Postoperatively, SVA averaged 83.9 mm obese and 20.4 mm non-obese (p = 0.002). Postoperative lumbar lordosis-pelvic incidence mismatch averaged 17.9° obese and 9.9° non-obese (p = 0.028). Both groups had improvement in ODI scores with no difference in postoperative ODI scores between groups (p = 0.090). Similarly, both groups had decreased VAS scores for back and leg pain with no difference between groups postoperatively. Twenty (33.9%) non-obese patients versus 7 (38.9%) obese patients had complications (p = 0.452).ConclusionsOur results suggest that obesity does not negatively impact complication rate or clinical outcomes in patients with ASD treated via MIS approaches.

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