Post-operative morbidity of the obese patient undergoing posterior lumbar surgery
AbstractBackground: Obese patients are making up an increasing proportion of patients being seen by spine surgeons in hospital today.
Objective: To evaluate the perioperative morbidity in obese patients compared with non-obese patients who underwent posterior lumbar spinal surgery.
Study design: A prospective case series.
Patients: One hundred consecutive patients appearing for lumbar spine surgery at Hospital for Joint Diseases Orthopaedic Institute from August 2008 to June 2009.
Outcome measures: Post-operative morbidity measures – infection, seroma, pulmonary embolism, urinary tract infection, neurological injury and dural tears.
Methods: One hundred consecutive patients undergoing posterior lumbar spine surgery were enrolled in the study. Three fellowship trained attending orthopaedic spine surgeons performed the lumbar spine surgeries. The procedures consisted of lumbar discectomy, single and multi-level laminectomy, and single and multi level fusions. Obesity was defined as a body mass index greater than thirty. The patients were divided into two groups, obese and non-obese, and then subsequently subdivided into
five groups based on the surgical procedure that was performed.
Results: Thirty-five of one hundred patients were classified as obese. The average weight of the patients within the obese group was 215.11 lbs compared with 170.04 lbs in the non-obese group. There were four postoperative infections, only one of which was in the obese population. There was no difference on other post-operative morbidity measures in the two groups.
Conclusions: There did not appear to be an increased risk of perioperative complications in obese patients as compared to non-obese patients in this study. We believe that lumbar spine surgery should not be withheld from obese patients, when surgery is properly indicated.