Outcome of non-instrumented lumbar spinal surgery in obese patients: a systematic review

Ghobrial, J.; Gadjradj, P.; Harhangi, B.; Dammers, R.; Vleggeert-Lankamp, C.

doi:doi:10.1080/02688697.2021.1885615

IntroductionLumbar spinal decompression procedures are well known in their techniques and outcomes. However, outcomes of lumbar spinal surgery in patients with obesity are relatively unknown. The aim of this review is to assess the effect of obesity on post-operative outcomes of lumbar non-instrumented decompressive spinal surgery.Methods and materialsA literature search through PubMed, Embase, Web of Science and Cochrane was performed. Articles were included if they reported outcomes of obese patients after non-instrumented lumbar decompression surgery, if these outcomes were described using patient-reported outcome measures and if there was at least two months of follow-up. Risk of bias was assessed using an adjusted version of the Cowley score.ResultsFrom the 222 unique articles, 14 articles, comprising 13,653 patients, met the inclusion criteria. Eight out of 14 studies had a low risk of bias, while the remaining six had an intermediate risk of bias. Thirteen studies evaluated...Show moreIntroductionLumbar spinal decompression procedures are well known in their techniques and outcomes. However, outcomes of lumbar spinal surgery in patients with obesity are relatively unknown. The aim of this review is to assess the effect of obesity on post-operative outcomes of lumbar non-instrumented decompressive spinal surgery.Methods and materialsA literature search through PubMed, Embase, Web of Science and Cochrane was performed. Articles were included if they reported outcomes of obese patients after non-instrumented lumbar decompression surgery, if these outcomes were described using patient-reported outcome measures and if there was at least two months of follow-up. Risk of bias was assessed using an adjusted version of the Cowley score.ResultsFrom the 222 unique articles, 14 articles, comprising 13,653 patients, met the inclusion criteria. Eight out of 14 studies had a low risk of bias, while the remaining six had an intermediate risk of bias. Thirteen studies evaluated leg and back pain, and the vast majority demonstrated less decrease in pain in the obese group. Six studies evaluated disability and all but one showed less improvement in obese patients. Five studies evaluated functionality and wellbeing and all but one showed less satisfactory outcome in obese patients.ConclusionsLiterature does not reveal a difference in clinical outcome nor in complications in patients undergoing non-instrumented lumbar surgery with a BMI lower than 30 or equal to or higher than 30. This may be used by physicians to inform patients prior to lumbar decompression surgery.Show less

Leiden University Scholarly Publications

View statistics

Documents

In Collections

Outcome of non-instrumented lumbar spinal surgery in obese patients: a systematic review