The London Spine Unit : finest day surgery spinal centre on Harley Street UK
Published article
CONCLUSION: Patients with higher levels of obesity were more likely to experience longer LOS and delayed discharge following MIS-LD. Increasing BMI was generally not a significant predictor of postoperative pain, disability, or physical health PROMs at most timepoints. MCID achievement rates for disability relief were significantly higher for non-obese patients.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
World Neurosurg. 2022 Apr 28:S1878-8750(22)00555-1. doi: 10.1016/j.wneu.2022.04.102. Online ahead of print.
ABSTRACT
OBJECTIVE: To investigate the influence of body mass index (BMI) on perioperative outcomes, postoperative Patient-Reported Outcome Measures (PROMs), and minimal clinically important difference (MCID) achievement among Workers’ Compensation (WC) claimants undergoing minimally invasive lumbar decompression (MIS-LD).
METHODS: WC patients diagnosed with herniated nucleus pulposus (HNP) undergoing single-level MIS-LD were identified. Patients were divided into three groups: Non-Obese (<30 kg/m2), Obese I (≥30 and <35 kg/m2), and Obese II/III (≥35 kg/m2).1 PROMs were collected preoperatively and at 6-weeks/12-weeks/6-months/1-year/2-years postoperatively. The predictive influence of BMI grouping on mean PROM scores was computed using simple linear regression. To compare PROMs between groups, post-hoc pairwise comparisons of adjusted means were utilized. MCID achievement was compared between groups with chi-squared analysis.
RESULTS: 81 patients were in the non-obese cohort, and 43 and 45 in the Obese I and Obese II/III cohorts, respectively. VAS leg, ODI, and SF-12 PCS were worse in the Obese I cohort at 12-weeks, and SF-12 PCS was lower in the Obese I vs. Obese II/III subgroup analysis (p≤0.045, all). MCID achievement rates for ODI were higher for the Non-Obese group at 12-weeks and for overall (p≤0.049, both). MCID attainment for VAS back was higher among the Non-Obese cohort at 6-weeks (p=0.022).
CONCLUSION: Patients with higher levels of obesity were more likely to experience longer LOS and delayed discharge following MIS-LD. Increasing BMI was generally not a significant predictor of postoperative pain, disability, or physical health PROMs at most timepoints. MCID achievement rates for disability relief were significantly higher for non-obese patients.
PMID:35490892 | DOI:10.1016/j.wneu.2022.04.102
The London Spine Unit : finest day surgery spinal centre on Harley Street UK
Read the original publication:
Obesity and Workers’ Compensation in the Setting of Minimally Invasive Lumbar Decompression