Preoperative obesity and outcome of lumbar disc surgery

• 出 处: 中华物理医学与康复杂志
• 发表日期: 2017年39期

BACKGROUND AND OBJECTIVE

Obesity has been implicated as an important factor in the clinical decision making for patients with lumbar intervertebral herniation. During surgery, obese patients present specific technical challenges, and have an increased risk of perioperative complications, including wound infection, blood loss and increased hospital stay. This prospective study explored the functional outcomes of obese patients after lumbar disc surgery.

METHODS

This prospective study included adults with isolated radicular symptoms secondary to lumbar disc herniation. Body mass index (BMI) was calculated prior to open lumbar microdiscectomy. Outcome measures included a visual analog score to assess the severity of symptoms, the Rowland Morris Disability Questionnaire and the SF-36 Health Survey. In addition, return to work and return to driving were documented. Obesity was defined as a BMI of 30 kg/m² or above.

RESULTS

Of the 107 participants, 34.5% were obese. Prior to surgery, 66.2% of the non-obese and 55.6% of the obese patients were working, with the loss of employment attributed to pain. At three and 12 months, no significant differences were seen between the groups in improvement in back pain, leg pain, paresthesias or numbness. Postoperative quality of life scores improved significantly in both groups at three and 12 months post-surgery, with no significant difference between the two groups (P＝0.119). At three and 12 months, the groups did not differ significantly in the percentage who returned to work, returned to driving or perceived their surgery as successful.

CONCLUSION

This prospective study of patients undergoing microscopic lumbar discectomy found that obesity did not significantly impact improvement in quality of life, return to work or improvement in pain.