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A comparison study on patient-reported outcome between obese and non-obese patients with central lumbar spinal stenosis undergoing surgical decompression : 14,984 patients in the National Swedish Quality Registry for Spine Surgery

Hareni, Niyaz LU ; Gudlaugsson, Kari LU ; Strömqvist, Fredrik LU ; Rosengren, Björn E. LU and Karlsson, Magnus K. LU (2022) In Acta Orthopaedica 93. p.880-886
Abstract

Background and purpose — Obesity has been associated with inferior outcomes after laminectomy due to central lumbar spinal stenosis (CLSS); we evaluated whether this occurs in surgery on national bases. Patients and methods — We retrieved pre-and 1-year postoperative data from the National Swedish Quality Registry for Spine Surgery regarding patients aged ≥ 50 with laminectomy due to CLSS in 2005–2018. 4,069 patients had normal weight, 7,044 were overweight, 3,377 had class I obesity, 577 class II obesity, and 94 class III obesity (“morbid obesity”). Patient-reported outcome included satisfaction after 1 year, leg pain (Numerical Rating Scale [NRS], rating 0–10), disability (Oswestry Disability Index [ODI], rating 0–100). Complications... (More)

Background and purpose — Obesity has been associated with inferior outcomes after laminectomy due to central lumbar spinal stenosis (CLSS); we evaluated whether this occurs in surgery on national bases. Patients and methods — We retrieved pre-and 1-year postoperative data from the National Swedish Quality Registry for Spine Surgery regarding patients aged ≥ 50 with laminectomy due to CLSS in 2005–2018. 4,069 patients had normal weight, 7,044 were overweight, 3,377 had class I obesity, 577 class II obesity, and 94 class III obesity (“morbid obesity”). Patient-reported outcome included satisfaction after 1 year, leg pain (Numerical Rating Scale [NRS], rating 0–10), disability (Oswestry Disability Index [ODI], rating 0–100). Complications were also retrieved. Results — 1-year postoperatively, 69% of patient of normal weight, 67% who were overweight, and 62% with obesity (classes I–III aggregated) were satisfied (p < 0.001) and 62%, 60%, and 57% in obese groups I–III, respectively (p = 0.7). NRS leg pain improved in normal-weight patients by 3.5 (95% CI 3.4–3.6), overweight by 3.2 (CI 3.1–3.2), and obese by 2.6 (CI 2.5–2.7), and 2.8 (CI 2.7–2.9), 2.5 (CI 2.2–2.7), and 2.6 (CI 2.0–3.2) in obese classes I–III, respec-tively. ODI improved in normal weight by 19 (CI 19–20), overweight by 17 (CI 17–18), and obese by 14 (CI 13–15), and 16 (CI 15–17), 14 (CI 13–16), 14 (CI 11–18) in obese classes I–III, respectively. 8.1% of normal weight, 7.0% of overweight, and 8.1% of obese patients suffered complications (p = 0.04) and 8.1%, 7.0%, and 17% among obese classes I–III, respectively (p < 0.01). Conclusion — Most obese patients are satisfied after laminectomy due to CLSS, even if satisfaction rate is inferior compared with normal-weight patients. The morbidly obese have more complications than patients with lower BMI.

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published
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in
Acta Orthopaedica
volume
93
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • pmid:36445071
  • scopus:85143057791
ISSN
1745-3674
DOI
10.2340/17453674.2022.5254
language
English
LU publication?
yes
id
7a07f601-0c76-4be5-9842-5415d2f468f7
date added to LUP
2022-12-27 10:44:09
date last changed
2024-04-18 16:56:59
@article{7a07f601-0c76-4be5-9842-5415d2f468f7,
  abstract     = {{<p>Background and purpose — Obesity has been associated with inferior outcomes after laminectomy due to central lumbar spinal stenosis (CLSS); we evaluated whether this occurs in surgery on national bases. Patients and methods — We retrieved pre-and 1-year postoperative data from the National Swedish Quality Registry for Spine Surgery regarding patients aged ≥ 50 with laminectomy due to CLSS in 2005–2018. 4,069 patients had normal weight, 7,044 were overweight, 3,377 had class I obesity, 577 class II obesity, and 94 class III obesity (“morbid obesity”). Patient-reported outcome included satisfaction after 1 year, leg pain (Numerical Rating Scale [NRS], rating 0–10), disability (Oswestry Disability Index [ODI], rating 0–100). Complications were also retrieved. Results — 1-year postoperatively, 69% of patient of normal weight, 67% who were overweight, and 62% with obesity (classes I–III aggregated) were satisfied (p &lt; 0.001) and 62%, 60%, and 57% in obese groups I–III, respectively (p = 0.7). NRS leg pain improved in normal-weight patients by 3.5 (95% CI 3.4–3.6), overweight by 3.2 (CI 3.1–3.2), and obese by 2.6 (CI 2.5–2.7), and 2.8 (CI 2.7–2.9), 2.5 (CI 2.2–2.7), and 2.6 (CI 2.0–3.2) in obese classes I–III, respec-tively. ODI improved in normal weight by 19 (CI 19–20), overweight by 17 (CI 17–18), and obese by 14 (CI 13–15), and 16 (CI 15–17), 14 (CI 13–16), 14 (CI 11–18) in obese classes I–III, respectively. 8.1% of normal weight, 7.0% of overweight, and 8.1% of obese patients suffered complications (p = 0.04) and 8.1%, 7.0%, and 17% among obese classes I–III, respectively (p &lt; 0.01). Conclusion — Most obese patients are satisfied after laminectomy due to CLSS, even if satisfaction rate is inferior compared with normal-weight patients. The morbidly obese have more complications than patients with lower BMI.</p>}},
  author       = {{Hareni, Niyaz and Gudlaugsson, Kari and Strömqvist, Fredrik and Rosengren, Björn E. and Karlsson, Magnus K.}},
  issn         = {{1745-3674}},
  language     = {{eng}},
  pages        = {{880--886}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Orthopaedica}},
  title        = {{A comparison study on patient-reported outcome between obese and non-obese patients with central lumbar spinal stenosis undergoing surgical decompression : 14,984 patients in the National Swedish Quality Registry for Spine Surgery}},
  url          = {{http://dx.doi.org/10.2340/17453674.2022.5254}},
  doi          = {{10.2340/17453674.2022.5254}},
  volume       = {{93}},
  year         = {{2022}},
}