Weight Change and Clinical Outcomes Following Adult Spinal Deformity Surgery in Overweight and Obese Patients.

Overview

abstract

STUDY DESIGN: Retrospective comparative study. SUMMARY OF BACKGROUND DATA: The effect of spine surgery on postoperative weight loss or weight gain in overweight and obese spinal deformity patients is unknown. OBJECTIVE: To evaluate the postoperative outcomes and weight changes in adult patients undergoing spinal deformity surgery. MATERIALS AND METHODS: A total of 104 adult patients undergoing primary spinal deformity surgery were enrolled. All patients had a minimum 2-year follow-up (average, 50.1 months). Preoperative and latest follow-up, body mass index (BMI), Oswestry Disability Index, Scoliosis Research Society (SRS)-22 self-image and SRS outcomes scores were collected. Instrumented levels, estimated blood loss, major and minor complications, length of hospitalization, and hospital discharge status were also reviewed and compared. RESULTS: A total of 66 patients were overweight (BMI > 25-29.9; average, 26.9) (Group OW), whereas 38 patients were obese (BMI > 30; average, 33.5) (Group OB). The average age was 54.5 in Group OW and 48.6 in Group OB (p < .01). Postoperatively, significant changes were not found in the BMI for Group OW, 27.2 (26.9-27.2; p < .39), and for Group OB, 35 (33.5-35; p < .06). Postoperatively, significant improvements were seen in both groups for Oswestry Disability Index (36.1-21.8, Group OW; 44.1-24.4, Group OB; p <.001), SRS self-image (2.9-3.7, Group OW; 2.6-3.8, Group OB; p < .001) and SRS score (3.1-3.8, Group OW; 2.9-3.8, Group OB; p < .001). There were no significant differences in complications between groups. CONCLUSIONS: As a group, overweight and obese primary spinal deformity patients did not demonstrate significant weight gain or weight loss from preoperative to latest follow-up. However, both overweight and obese patients had significant improvements in outcome scores at latest follow-up and equivalent rates of complications.