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A Meta-analysis of the Impact of Bariatric Surgery on Back Pain

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Abstract

Background

The functional aspects of obesity are increasingly recognised as a significant clinical and public health concern. Whilst there is substantial evidence for the beneficial impact of bariatric surgery on metabolic and cardiovascular disease, there is less understanding of the quantitative effect of bariatric surgery on back pain. The aim of this meta-analysis was to assess the impact of bariatric surgery on back pain in reported studies.

Methods

Medline, Embase, conference proceedings and reference lists were searched for studies assessing quantitative back pain scores both before and after bariatric surgery. The primary outcome was visual analogue score for back pain pre- and post-bariatric surgery. Secondary outcomes were change in BMI, SF-36 quality of life scores and Oswestry Disability Index (ODI) scores. Weighted mean differences (MD) were calculated for continuous outcomes.

Results

Seven studies were included in the analysis of 246 patients undergoing bariatric surgery. Mean study follow-up was between 3 and 24 months. There was a statistically significant reduction in visual analogue score for back pain following bariatric surgery (MD − 3.01; 95% CI − 4.19 to − 1.89; p < 0.001). Bariatric surgery also resulted in statistically significant improvements in BMI, SF-36 score and ODI score.

Conclusions

Bariatric surgery produces significant and quantifiable reductions in back pain. This may be commuted through reductions in axial load or improved quality of life, but further studies will improve understanding and aid preoperative counselling.

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References

  1. Wang YC, McPherson K, Marsh T, et al. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011;378(9793):815–25. https://doi.org/10.1016/S0140-6736(11)60814-3.

    Article  PubMed  Google Scholar 

  2. Engin AB, Engin A. Obesity and lipotoxicity. 2017;960 https://doi.org/10.1007/978-3-319-48382-5.

  3. Shanti H, Patel AG. Surgery for obesity. Medicine. 2019;47(3):184–7. https://doi.org/10.1016/j.mpmed.2018.12.011.

    Article  Google Scholar 

  4. Andersen RE, Crespo CJ, Bartlett SJ, et al. Relationship between body weight gain and significant knee, hip, and back pain in older Americans. Obes Res. 2003;11(10):1159–62. https://doi.org/10.1038/oby.2003.159.

    Article  PubMed  Google Scholar 

  5. Vincent HK, Ben-David K, Cendan J, et al. Effects of bariatric surgery on joint pain: a review of emerging evidence. Surg Obes Relat Dis. 2010;6(4):451–60. https://doi.org/10.1016/j.soard.2010.03.284.

    Article  PubMed  Google Scholar 

  6. Slim K, Nini E, Forestier D, et al. Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg. 2003;73(9):712–6. https://doi.org/10.1046/j.1445-2197.2003.02748.x.

    Article  PubMed  Google Scholar 

  7. Dersimonian; Laird, 9.4.3.1 Random effects (Dersimonian And Laird). Handbook-5-1.Cochrane.Org. [Online]. Available: https://handbook-5-1.cochrane.org/chapter_9/9_4_3_1_random_effects_dersimonian_and_laird_method_for.htm.

  8. Grant J, Hunter A. Measuring inconsistency in knowledgebases. J Intell Inf Syst. 2006;27(2):159–84. https://doi.org/10.1007/s10844-006-2974-4.

    Article  Google Scholar 

  9. Khoueir P, Black MH, Crookes PF, et al. Prospective assessment of axial back pain symptoms before and after bariatric weight reduction surgery. Spine J. 2009;9(6):454–63. https://doi.org/10.1016/j.spinee.2009.02.003.

    Article  PubMed  Google Scholar 

  10. Melissas J, Kontakis G, Volakakis E, et al. The effect of surgical weight reduction on low back pain. Obes Surg. 2005;15:378–81.

    Article  Google Scholar 

  11. Josbeno DA, Jakicic JM, Hergenroeder A, et al. Physical activity and physical function changes in obese individuals after gastric bypass surgery. Surg Obes Relat Dis. 2010;6(4):361–6. https://doi.org/10.1016/j.soard.2008.08.003.

    Article  PubMed  Google Scholar 

  12. Koulischer S, Cadière B, Cadière GB, et al. Evolution des douleurs lombaires après chirurgie bariatrique. Rev Med Brux. 2015;36(3):147–51.

    CAS  PubMed  Google Scholar 

  13. Lidar Z, Behrbalk E, Regev GJ, et al. Intervertebral disc height changes after weight reduction in morbidly obese patients and its effect on quality of life and radicular and low back pain. Spine (Phila Pa 1976). 2012;37(23):1947–52. https://doi.org/10.1097/BRS.0b013e31825fab16.

    Article  Google Scholar 

  14. Çakır T, Oruç MT, Aslaner A, et al. The effects of laparoscopic sleeve gastrectomy on head, neck, shoulder, low back and knee pain of female patients. Int J Clin Exp Med. 2015;8(2):2668–73.

    PubMed  PubMed Central  Google Scholar 

  15. Noshchenko A, Lindley EM, Burger EL, et al. What is the clinical relevance of radiographic nonunion after single-level lumbar interbody arthrodesis in degenerative disc disease?: A meta-analysis of the YODA project database. Spine (Phila Pa 1976). 2016;41(1):9–17. https://doi.org/10.1097/BRS.0000000000001113.

    Article  Google Scholar 

  16. Kauppila LI. Atherosclerosis and disc degeneration/low-back pain – a systematic review. J Vasc Surg. 2009;49(6):1629. https://doi.org/10.1016/j.jvs.2009.04.030.

    Article  Google Scholar 

  17. Lupoli R, di Minno MND, Guidone C, et al. Effects of bariatric surgery on markers of subclinical atherosclerosis and endothelial function: a meta-analysis of literature studies. Int J Obes. 2016;40(3):395–402. https://doi.org/10.1038/ijo.2015.187.

    Article  CAS  Google Scholar 

  18. Chen R, Takahashi T, Kanda T. Bariatric surgery for morbid obesity [14]. N Engl J Med. 2007;357(11):1159. https://doi.org/10.1093/med/9780199846085.003.0030.

    Article  CAS  PubMed  Google Scholar 

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Funding

Mr. Andrew Currie and Professor Christopher Pring are receivers of research grant from Medtronic, outside of the submitted work.

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Authors and Affiliations

  1. Department of General Surgery, Royal Surrey County Hospital, Guildford, UK

    Irena Stefanova

  2. Regional Oesophagogastric Unit, Royal Surrey County Hospital, Guildford, UK

    Andrew C. Currie

  3. Department of Bariatric Surgery, St Richard’s Hospital, Chichester, UK

    Richard C. Newton, Guy Slater, William Hawkins & Christopher Pring

  4. Department of Bariatric Surgery and Diabetes, St Richard’s Hospital, Chichester, UK

    Lorraine Albon

Authors
  1. Irena Stefanova
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  2. Andrew C. Currie
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  5. Guy Slater
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Correspondence to Irena Stefanova.

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Irena Stefanova and Andrew C Currie are considered joint first authors.

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Stefanova, I., Currie, A.C., Newton, R.C. et al. A Meta-analysis of the Impact of Bariatric Surgery on Back Pain. OBES SURG 30, 3201–3207 (2020). https://doi.org/10.1007/s11695-020-04713-y

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  • DOI: https://doi.org/10.1007/s11695-020-04713-y

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