Abstract
Introduction
Obesity is a known risk factor for many medical complications. Spinal surgery in overweight or obese patients poses specific challenges related to technical difficulties and risks of complications. Minimally invasive spinal (MIS) surgery has been developed with the purpose of decreasing post operative pain, operative blood loss and to promote early ambulation while offering the same outcomes of traditional open techniques. Nonetheless, there is a paucity of information as to whether these techniques are safe and their results reproducible in overweight or obese patients. We report perioperative outcomes in a retrospective cohort of overweight or obese patients after minimally invasive lumbar spine surgery.
Material and Methods
Retrospective chart analysis of patients treated with minimally invasive techniques for lumbar spinal pathology was performed, starting from January 2007 to December 2011. Fifty – seven patients with a body mass index (BMI) greater than or equal to 25 kg/m2 were included for analysis. 40 patients with a BMI lower than 25 kg/m2 were included for comparison. Multivariate logistic regression analysis was performed.
Results
Out of the 97 patients included in the study, 9 presented complications. These were distributed by BMI groups as follows: Two patients in the group below BMI 25 kg/m2; five patients in the group between 25 and 29.9 kg/m2, and two patients in the group above BMI 30. There were no reported mortality cases. After multivariate logistic regression analysis, none of the variables observed (BMI, age, gender, type of fusion) demonstrated a statistically significant increase in morbidity.
Conclusion
MIS surgery doesn't appear to have a higher risk of perioperative complications in overweight or obese patients with lumbar spine pathology.