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Increased Body Mass Index Negatively Affects Patient Satisfaction After a Posterior Fusion and Instrumentation for Adolescent Idiopathic Scoliosis

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Abstract

Study Design

Retrospective.

Summary of Background Data

Previous studies have reported the correlation of body mass index (BMI) with non-spine surgical outcomes; however, only a few reviewed the correlation of BMI to outcomes after spine surgery.

Objectives

To review the influence of preoperative BMI on the follow-up clinical and functional outcomes after posterior-only fusion (PSF) and instrumentation for adolescent idiopathic scoliosis in a larger patient cohort.

Methods

Retrospective review of a consecutive series of patients treated with PSF for adolescent idiopathic scoliosis from 2002 to 2009 at a single institution. There were 3 categories: underweight (UW), normal weight (NML), and overweight (OW). Percent correction of the major curve was collected at 2 years postoperatively and patient outcome scores were analyzed preoperatively and at 2 years postoperatively. Differences between groups were analyzed using analysis of variance, with p <.05.

Results

A total of 459 patients at an average age of 15.0 years (range, 10.0—21.3 years) treated with PSF instrumentation were included. At 2 years, all groups achieved and maintained equal percent correction with no differences between groups. Regarding preoperative Scoliosis Research Society (SRS) outcome scores, OW patients reported more pain than NML (p =.002) and UW patients (p <.001) despite less reported activity than for the NML (p =.033) and UW groups (p =.005). The total SRS score was also lower in the OW patients compared with NML (p =.009) and UW patients (p =.002). At 2 years, the OW group reported more pain than the UW (p =.031) and NML groups (p =.018), lower mental scores (p =.011) and lower SRS total scores (p =.005) than the NML group.

Conclusions

At follow-up, preoperative overweight adolescents reported more pain and lower mental, activity, and appearance domain scores after surgery than UW and NML patients despite equal percent curve correction. This information may help the surgeon with preoperative counseling of OW patients by stressing that their own assessment of outcome is influenced by BMI, which may help promote a healthy weight management program in this patient group.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX, 75219, USA

    Adriana De La Rocha MS, Anna McClung BSN & Daniel J. Sucato MD, MS

Authors
  1. Adriana De La Rocha MS
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  2. Anna McClung BSN
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  3. Daniel J. Sucato MD, MS
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Corresponding author

Correspondence to Daniel J. Sucato MD, MS.

Additional information

Author disclosures: AD (none); AM (travel/accommodations/meeting expenses from Growing Spine Foundation and Scoliosis Research Society); DJS (board membership with Scoliosis Research Society; grant from NuVasive; royalties from Medtronic; other support from AAOS CME and YOC AAOS).

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De La Rocha, A., McClung, A. & Sucato, D.J. Increased Body Mass Index Negatively Affects Patient Satisfaction After a Posterior Fusion and Instrumentation for Adolescent Idiopathic Scoliosis. Spine Deform 2, 208–213 (2014). https://doi.org/10.1016/j.jspd.2013.12.005

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  • DOI: https://doi.org/10.1016/j.jspd.2013.12.005

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