Effect of Obesity on Radiographic Alignment and Short-Term Complications After Surgical Treatment of Adult Cervical Deformity.

dc.contributor.author

Passias, Peter G

dc.contributor.author

Poorman, Gregory W

dc.contributor.author

Horn, Samantha R

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Jalai, Cyrus M

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Bortz, Cole

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Segreto, Frank

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Diebo, Bassel M

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Daniels, Alan

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Hamilton, D Kojo

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Sciubba, Daniel

dc.contributor.author

Smith, Justin

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Neuman, Brian

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Shaffrey, Christopher I

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LaFage, Virginie

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LaFage, Renaud

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Schwab, Frank

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Bess, Shay

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Ames, Christopher

dc.contributor.author

Hart, Robert

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Soroceanu, Alexandra

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Mundis, Gregory

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Eastlack, Robert

dc.contributor.author

International Spine Study Group

dc.date.accessioned

2023-06-20T13:46:20Z

dc.date.available

2023-06-20T13:46:20Z

dc.date.issued

2019-05

dc.date.updated

2023-06-20T13:46:19Z

dc.description.abstract

Objective

We investigated the 30-day complication incidence and 1-year radiographic correction in obese patients undergoing surgical treatment of cervical deformity.

Methods

The patients were stratified according to World Health Organization's definition for obesity: obese, patients with a body mass index of ≥30 kg/m2; and nonobese, patients with a body mass index of <30 kg/m2. The patients had undergone surgery for the treatment of cervical deformity. The patient baseline demographic, comorbidity, and radiographic data were compared between the 2 groups at baseline and 1 year postoperatively. The 30-day complication incidence was stratified according to complication severity (any, major, or minor), and type (cardiopulmonary, dysphagia, infection, neurological, and operative). Binary logistic regression models were used to assess the effect of obesity on developing those complications, with adjustment for patient age and levels fused.

Results

A total of 124 patients were included, 53 obese and 71 nonobese patients. The 2 groups had a similar T1 slope minus cervical lordosis (obese, 37.2° vs. nonobese, 36.9°; P = 0.932) and a similar C2-C7 (-5.9° vs. -7.3°; P = 0.718) and C2-C7 (50.1 mm vs. 44.1 mm; P = 0.184) sagittal vertical axis. At the 1-year follow-up examination, the T1 pelvic angle (1.0° vs. -3.1°; P = 0.021) and C2-S1 sagittal vertical axis (-5.9 mm vs. -35.0 mm; P = 0.036) were different, and the T1 spinopelvic inclination (-1.0° vs. -2.9°; P = 0.123) was similar. The obese patients had a greater risk of overall short-term complications (odds ratio, 2.5; 95% confidence interval, 1.1-6.1) and infectious complications (odds ratio, 5.0; 95% confidence interval, 1.0-25.6).

Conclusions

Obese patients had a 5 times greater odds of developing infections after surgery for adult cervical deformity. Obese patients also showed significantly greater pelvic anteversion after cervical correction.
dc.identifier

S1878-8750(19)30364-X

dc.identifier.issn

1878-8750

dc.identifier.issn

1878-8769

dc.identifier.uri

https://hdl.handle.net/10161/28212

dc.language

eng

dc.publisher

Elsevier BV

dc.relation.ispartof

World neurosurgery

dc.relation.isversionof

10.1016/j.wneu.2019.01.248

dc.subject

International Spine Study Group

dc.subject

Cervical Vertebrae

dc.subject

Humans

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Surgical Wound Infection

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Spinal Curvatures

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Obesity

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Postoperative Complications

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Treatment Outcome

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Middle Aged

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Female

dc.subject

Male

dc.title

Effect of Obesity on Radiographic Alignment and Short-Term Complications After Surgical Treatment of Adult Cervical Deformity.

dc.type

Journal article

duke.contributor.orcid

Passias, Peter G|0000-0002-1479-4070|0000-0003-2635-2226

duke.contributor.orcid

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

pubs.begin-page

e1082

pubs.end-page

e1088

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Orthopaedic Surgery

pubs.organisational-group

Neurosurgery

pubs.publication-status

Published

pubs.volume

125

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