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

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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.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Washington University School of Medicine, 660 S Euclid Avenue, Campus, Box 8233, Saint Louis, MO, 63110, USA

    Addisu Mesfin MD, Lawrence G. Lenke MD, Keith H. Bridwell MD, Jennifer M. Jupitz BS, Usman Akhtar BA, Jeremy L. Fogelson MD, Stuart Hershman MD, Han Jo Kim MD & Linda A. Koester BS

Authors
  1. Addisu Mesfin MD
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  2. Lawrence G. Lenke MD
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  3. Keith H. Bridwell MD
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  4. Jennifer M. Jupitz BS
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  5. Usman Akhtar BA
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  6. Jeremy L. Fogelson MD
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  7. Stuart Hershman MD
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  8. Han Jo Kim MD
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  9. Linda A. Koester BS
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Corresponding author

Correspondence to Lawrence G. Lenke MD.

Additional information

Conflicts of Interest and Source of Funding: None of the authors received financial support in relation to this manuscript. Washington University, Department of Orthopaedic Surgery - Spine Service received grant monies from Axial Biotech and DePuy Spine, and AOSpine & SRS (Scoli-RISK-1 study), fellowship funding from AOSpine North America (funds/fellow year).

Author disclosures: AM (none); LGL board membership with Scoliosis Research Society, Journal of Spinal Disorders & Techniques, Spine Journal, www.spineuniverse.com, www.iscoliosis.com, The Spine Journal, The Journal of Pediatric Orthopaedics, Scoliosis, Backtalk, Journal of Neurosurgery: Spine; grants from Axial Biotech and DePuy; payment for lectures including service on speakers bureaus from DePuy, K2M; patents from Medtronic; royalties from Medtronic, Quality Medical Publishing; travel/accommodations/meeting expenses from Broadwater, Scoliosis Research Society, Medtronic, AMCICO, AOSpine, DePuy, Dubai Spine Society, Spinal Deformity Study Group, International Society on Scoliosis Orthopaedic and Treatment, The Spinal Research Foundation, Seattle Science Foundation; fellowship grant from AOSpine; philantropic research funding from Fox Family Foundation; KHB (grants from NIH); JMJ (none); UA (none); JLF (none); SH (none); HJK (consultancy for Spinal Innovation Advisory Board and Medtronic; royalties from World Scientific Publishers); LAK (none).

Research was performed at Washington University School of Medicine, St. Louis, Missouri.

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Mesfin, A., Lenke, L.G., Bridwell, K.H. et al. Weight Change and Clinical Outcomes Following Adult Spinal Deformity Surgery in Overweight and Obese Patients. Spine Deform 1, 377–381 (2013). https://doi.org/10.1016/j.jspd.2013.07.002

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  • DOI: https://doi.org/10.1016/j.jspd.2013.07.002

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