Doctors, physiotherapists and patients know that being overweight is often a big challenge before, during and after spinal surgery. However, so far, there has been no scientific consensus on the long-term impact of the Body-Mass-Index on patients-reported spine surgery outcomes. In the prestigious Journal of neurosurgery Spine, colleagues at Duke University published an article examining differences in patient-reported outcomes within 12 and 24 months after spinal surgery.
A total of 31,765 patients were enrolled in the study. They are categorized based on their BMI as 1) normal weight (≤25 kg / sq. M.), 2) overweight (25–30 kg / sq. M.), 3) obesity (30–40 kg / sq. M.) and 4) morbid obesity (> 40 kg / sq. m.). Those who were obese and morbidly obese had significantly worse results concerning the Oswestry Disability Index (ODI) and the Visual Analog Scale for Lower Back Pain
(VAS-BP) than those with normal weight. The article also tells us something fundamental - the limit from which being overweight becomes a problem. The limit is a BMI of about 30 (e.g. height 180 cm and 95 kg.).
What does this mean for us? Should we surgeons refuse surgery to patients because they have a high BMI? No, but we must plan more time for surgery, a more extended stay in the hospital and much more effort after the operation for the patient-mobilization.
Here is a link to the original article:
Long-term impact of obesity on patient-reported outcomes and patient satisfaction after lumbar spine surgery: an observational study