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Impact of obesity on adult spinal deformity (ASD) long-segment spinal fusion radiographic and clinical outcomes – Lumbar Fusion

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The article is a retrospective chart review of patients who underwent long-segment fusion over a five-year period to determine the outcomes and complications, particularly in obese patients. The study found that obese patients showed comparable improvements in spinopelvic radiographic measurements and patient-reported outcome measures compared to non-obese patients. However, obese patients had an increased risk of cardiovascular complications, acute kidney injury, rod fractures, and reoperations. The study challenges the assumption that obese patients may not benefit from long-segment fusion surgeries, but highlights the need for appropriate counseling due to their elevated risk for post-operative and delayed hardware complications

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised treatment hospital in the world

Published article

: This study adds to a growing body of evidence linking demographic factors with risks of hardware failure. Further, this data challenges the assumption that obese patients may not receive sufficient benefit to be long-segment surgical candidates. However, given their elevated risk for post-operative and delayed hardware complications, obese patients should be appropriately counseling before undergoing surgery.

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Clin Neurol Neurosurg. 2024 Feb 21;238:108187. doi: 10.1016/j.clineuro.2024.108187. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective chart review of patients receiving long-segment fusion during a five-year period.OBJECTIVE: To determine whether obese patients receive comparable benefits when receiving long-segment fusion compared to non-obese patients and to identify factors that may predict hardware failure and post-surgical complications among obese,

Clin Neurol Neurosurg. 2024 Feb 21;238:108187. doi: 10.1016/j.clineuro.2024.108187. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective chart review of patients receiving long-segment fusion during a five-year period.

OBJECTIVE: To determine whether obese patients receive comparable benefits when receiving long-segment fusion compared to non-obese patients and to identify factors that may predict hardware failure and post-surgical complications among obese patients.

METHODS: Demographic, spinopelvic radiographic, patient-reported outcome measures (PROMs), and complications data was retrospectively collected from 120 patients who underwent long-segment fusion during a five-year period at one tertiary care medical center. Radiographic measurements were pelvic incidence, pelvic tilt (PT), lumbar lordosis, L4-S1 lordosis, thoracic kyphosis, sagittal vertical axis, PI-LL mismatch, and proximal junction cobb angle at upper instrumented vertebrae + 2 (UIV+2). PROMs were Oswestry disability index, numeric rating scale (NRS) Back Pain, NRS Leg Pain, RAND SF-36 pain, and RAND SF-36 physical functioning. Included patients were adults and had at least 2-years of postoperative follow-up. Descriptive and multivariate statistical analysis was performed with α = 0.05.

RESULTS: Patients with a BMI ≥ 30 (n=63) and patients with a BMI < 30 (n=57) demonstrated comparable improvements (P>0.05) for all spinopelvic radiographic measurements and PROMs. Each cohort demonstrated significant improvements from pre-assessment to post-assessment on nearly all spinopelvic radiographic measurements and PROMs (P<0.05), except PT and L4-S1 lordosis where neither group improved (p=0.95 and 0.58 for PT and P=0.23 and 0.11 for L4-S1 lordosis fornon-obese and obese cohorts respectively) and SF-36 physical functioning where the non-obese cohort not statistically improve (P=0.08). Patients with a BMI ≥ 30 demonstrated an increased incidence of cardiovascular complications (P=0.0293), acute kidney injury (P=0.0241), rod fractures (P=0.0293), and reoperations (P=0.0241) when compared to patients with a BMI < 30.

: This study adds to a growing body of evidence linking demographic factors with risks of hardware failure. Further, this data challenges the assumption that obese patients may not receive sufficient benefit to be long-segment surgical candidates. However, given their elevated risk for post-operative and delayed hardware complications, obese patients should be appropriately counseling before undergoing surgery.

PMID:38402706 | DOI:10.1016/j.clineuro.2024.108187

The London Spine Unit : most specialised treatment hospital in the world

Read the original publication:

Impact of obesity on adult spinal deformity (ASD) long-segment spinal fusion radiographic and clinical outcomes

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Clin Neurol Neurosurg. 2024 Feb 21;238:108187. doi: 10.1016/j.clineuro.2024.108187. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective chart review of patients receiving long-segment fusion during a five-year period.OBJECTIVE: To determine whether obese patients receive comparable benefits when receiving long-segment fusion compared to non-obese patients and to identify factors that may predict hardware failure and post-surgical complications among obese

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