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Back pain and sagittal spine alignment in obese patients eligible for bariatric surgery

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Abstract

Objective

The objective of this research was to evaluate the prevalence of cervical and lumbar pain in obese patients eligible for bariatric surgery and to investigate possible changes in sagittal spine alignment in these patients.

Methods

The following parameters were compared in 30 obese patients and a control group of 25 non-obese volunteers: body mass index, prevalence of cervical and lumbar pain assessed by visual analog scale (VAS), Neck Disability Index [NDI] and Oswestry Disability Index [ODI], as well as radiographic parameters of the spine and pelvis measured with Surgimap software.

Results

The cervical and lumbar VAS and the NDI and ODI were significantly worse in obese patients. Compared with the control group, the cervical sagittal vertical axis (cSVA) of the obese group had higher variance (p value = 0.0025) and the cervical lordosis was diminished (p value = 0.0023). Thoracic kyphosis, lumbar lordosis, and the pelvic parameters were not significantly different between the groups.

Conclusions

Obese patients demonstrated lower functional performance compared with their non-obese counterparts, while cervical lordosis was diminished and the cSVA was increased in obese patients.

Graphical abstract

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Acknowledgments

We thank Peter Mittwede, MD, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript. We thank Isabela Peixoto de Mello for drawing the figure representing the measures.

Funding

The study was performed using personal resources from the authors and exams performed at Hospital Federal de Ipanema as part of the pre-operative evaluation.

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Authors and Affiliations

  1. Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Silva Ramos 32, Rio de Janeiro, RJ, Brazil

    Alexandre Peixoto de Mello

  2. Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, Brazil

    Alexandre Peixoto de Mello

  3. Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil

    Glaucus Cajaty dos Santos Martins, Antônio Vítor de Abreu, Antonio Carlos Pires Carvalho & Maurício de Pinho Gama

  4. Hospital Federal de Ipanema (HFI), Rio de Janeiro, Brazil

    Glaucus Cajaty dos Santos Martins, André Raposo Heringer, Raphael Barbosa Gamallo & Luiz Felippe dos Santos Martins Filho

  5. Universidade de Brasília (UnB), Brasilia, Brazil

    Maurício de Pinho Gama

Authors
  1. Alexandre Peixoto de Mello
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  2. Glaucus Cajaty dos Santos Martins
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  3. André Raposo Heringer
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  8. Maurício de Pinho Gama
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Contributions

Alexandre Peixoto de Mello and Glaucus Cajaty dos Santos Martins designed the studies, analyzed data and wrote the manuscript. André Raposo Heringer and Raphael Barbosa Gamallo collected the data from the patients. Maurício de Pinho Gama revised the statistics. Luiz Felippe dos Santos Martins Filho, Antônio Vítor de Abreu and Antonio Carlos Pires Carvalho revised the analyzed data and the manuscript.

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Correspondence to Alexandre Peixoto de Mello.

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de Mello, A.P., Martins, G.C.d., Heringer, A.R. et al. Back pain and sagittal spine alignment in obese patients eligible for bariatric surgery. Eur Spine J 28, 967–975 (2019). https://doi.org/10.1007/s00586-019-05935-0

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