This article discusses a study that compared the outcomes of obese and non-obese patients who underwent a unilateral approach for decompressive lumbar laminectomy (DLL), a common procedure for lumbar stenosis. The study included 194 patients, with 105 classified as obese and 89 as non-obese. The results showed that obese patients had a significantly longer length of hospitalization compared to non-obese patients. Additionally, the obese group had a non-significantly increased length of operation and decreased blood loss. The peri-operative complication rates were similar between the two groups. Overall, the study highlights the importance of considering obesity as a factor in surgical planning and patient outcomes for DLL
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : finest spinal centre in London
Published article
CONCLUSIONS: Compared to the non-obese group, the obese group had significantly longer length of hospitalization, as well as non-significantly increased length of operation and decreased blood loss. The two groups had similar peri-operative complication rates.
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World Neurosurg. 2023 Aug 10:S1878-8750(23)01115-4. doi: 10.1016/j.wneu.2023.08.015. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective case-control OBJECTIVES: Decompressive lumbar laminectomy (DLL) is a common procedure for lumbar stenosis. A unilateral approach, unlike the traditional open approach, spares the posterior elements to mitigate the risk of iatrogenic instability associated with a DLL. Various minimally invasive techniques have been,
World Neurosurg. 2023 Aug 10:S1878-8750(23)01115-4. doi: 10.1016/j.wneu.2023.08.015. Online ahead of print.
ABSTRACT
STUDY DESIGN: Retrospective case-control OBJECTIVES: Decompressive lumbar laminectomy (DLL) is a common procedure for lumbar stenosis. A unilateral approach, unlike the traditional open approach, spares the posterior elements to mitigate the risk of iatrogenic instability associated with a DLL. Various minimally invasive techniques have been described but little attention has been aimed toward this specific microsurgical approach, particularly with regards to obese patients. The authors aimed to compare operative details, perioperative outcomes, and complication profiles between obese and non-obese patients.
METHODS: One hundred ninety-four patients that underwent bilateral laminectomy with unilateral approach by the study surgeon from July 2013 to June 2018 were included. Of these, 105 were classified as obese with body mass index (BMI)≥30.0 kg/m2 and 89 were non-obese with BMI<30.0 kg/m2. The obese and non-obese groups were compared; operative time, blood loss, and complications were assessed.
RESULTS: Operative time was non-significantly increased in the obese group (177 vs 166 minutes, p=0.21) and estimated blood loss was non-significantly lower (91 mL vs 97 mL, p=1.00) in the obese group. Durotomy rates (3 [2.9%] obese vs 2 [2.2%] non-obese, p=0.789) and postoperative wound drainage rates (4 [3.8%] obese vs 2 [3.8%] non-obese, p=0.92) did not significantly differ between the two groups. Length of stay was significantly longer in the obese group (1.5 vs 1.0 days, p=0.0005).
CONCLUSIONS: Compared to the non-obese group, the obese group had significantly longer length of hospitalization, as well as non-significantly increased length of operation and decreased blood loss. The two groups had similar peri-operative complication rates.
PMID:37572832 | DOI:10.1016/j.wneu.2023.08.015
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Minimally Invasive Bilateral Decompressive Lumbar Laminectomy With Unilateral Approach Among Obese Versus Non-Obese Patients
