Long-term impact of obesity on patient-reported outcomes and patient satisfaction after lumbar spine surgery: an observational study.

dc.contributor.author

Park, Christine

dc.contributor.author

Garcia, Alessandra N

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Cook, Chad

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Shaffrey, Christopher I

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Gottfried, Oren N

dc.date.accessioned

2023-06-19T19:49:51Z

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2023-06-19T19:49:51Z

dc.date.issued

2020-09

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2023-06-19T19:49:50Z

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Objective

Obese body habitus is a challenging issue to address in lumbar spine surgery. There is a lack of consensus on the long-term influence of BMI on patient-reported outcomes and satisfaction. This study aimed to examine the differences in patient-reported outcomes over the course of 12 and 24 months among BMI classifications of patients who underwent lumbar surgery.

Methods

A search was performed using the Quality Outcomes Database (QOD) Spine Registry from 2012 to 2018 to identify patients who underwent lumbar surgery and had either a 12- or 24-month follow-up. Patients were categorized based on their BMI as normal weight (≤ 25 kg/m2), overweight (25-30 kg/m2), obese (30-40 kg/m2), and morbidly obese (> 40 kg/m2). Outcomes included the Oswestry Disability Index (ODI) and the visual analog scale (VAS) for back pain (BP) and leg pain (LP), and patient satisfaction was measured at 12 and 24 months postoperatively.

Results

A total of 31,765 patients were included. At both the 12- and 24-month follow-ups, those who were obese and morbidly obese had worse ODI, VAS-BP, and VAS-LP scores (all p < 0.01) and more frequently rated their satisfaction as "I am the same or worse than before treatment" (all p < 0.01) compared with those who were normal weight. Receiver operating characteristic curve analysis revealed that the BMI cutoffs for predicting worsening disability and surgery dissatisfaction were 30.1 kg/m2 and 29.9 kg/m2 for the 12- and 24-month follow-ups, respectively.

Conclusions

Higher BMI was associated with poorer patient-reported outcomes and satisfaction at both the 12- and 24-month follow-ups. BMI of 30 kg/m2 is the cutoff for predicting worse patient outcomes after lumbar surgery.
dc.identifier

2020.6.SPINE20592

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1547-5654

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1547-5646

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https://hdl.handle.net/10161/28133

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eng

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Journal of Neurosurgery Publishing Group (JNSPG)

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Journal of neurosurgery. Spine

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10.3171/2020.6.spine20592

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AUC = area under the ROC curve

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MCID = minimal clinically important difference

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MD = mean difference

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NASS = North American Spine Society

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ODI = Oswestry Disability Index

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QOD = Quality Outcomes Database

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ROC = receiver operating characteristic

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VAS-BP = visual analog scale for back pain

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VAS-LP = VAS for leg pain

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lumbar spine surgery

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obesity

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patient satisfaction

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patient-reported outcomes

dc.title

Long-term impact of obesity on patient-reported outcomes and patient satisfaction after lumbar spine surgery: an observational study.

dc.type

Journal article

duke.contributor.orcid

Cook, Chad|0000-0001-8622-8361|0000-0002-5045-3281

duke.contributor.orcid

Shaffrey, Christopher I|0000-0001-9760-8386

pubs.begin-page

1

pubs.end-page

10

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1

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Duke

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School of Medicine

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Orthopaedic Surgery

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Duke Clinical Research Institute

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Orthopaedic Surgery, Physical Therapy

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Neurosurgery

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Population Health Sciences

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Published

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34

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