Do obese patients undergoing surgery for grade 1 spondylolisthesis have worse outcomes at 5 years’ follow-up? A QOD study

作者：Samer G. Zammar, Vardhaan Ambati, Timothy J. Yee, Arati Patel, Vivian Le, Nima Alan, Domagoj Coric, Eric A. Potts, Erica F. Bisson, Jack Knightly, Kai-Ming Fu, Kevin T. Foley, Mark E. Shaffrey, Mohamad Bydon, Dean Chou, Andrew K. Chan, Scott A. Meyer, Anthony Asher, Christopher I. Shaffrey, Jonathan R. Slotkin, Michael Wang, Regis W. Haid, Steven D. Glassman, Paul Park, Michael S. Virk, Praveen V. Mummaneni · 发表于：Journal of Neurosurgery Spine · 年份：2024 · DOI：10.3171/2024.5.spine24125 · 被引用次数：7 · 研究领域：Spine and Intervertebral Disc Pathology、Scoliosis diagnosis and treatment、Bone health and osteoporosis research

OBJECTIVE: The long-term effects of increased body mass index (BMI) on surgical outcomes are unknown for patients who undergo surgery for low-grade lumbar spondylolisthesis. The goal of this study was to assess long-term outcomes in obese versus nonobese patients after surgery for grade 1 spondylolisthesis. METHODS: Patients who underwent surgery for grade 1 spondylolisthesis at the Quality Outcomes Database's 12 highest enrolling sites (SpineCORe group) were identified. Long-term (5-year) outcomes were compared for patients with BMI ≥ 35 versus BMI < 35. RESULTS: In total, 608 patients (57.6% female) were included. Follow-up was 81% (excluding patients who had died) at 5 years. The BMI ≥ 35 cohort (130 patients, 21.4%) was compared to the BMI < 35 cohort (478 patients, 78.6%). At baseline, patients with BMI ≥ 35 were more likely to be younger (58.5 ± 11.4 vs 63.2 ± 12.0 years old, p < 0.001), to present with both back and leg pain (53.8% vs 37.0%, p = 0.002), and to require ambulation assistance (20.8% vs 9.2%, p < 0.001). Furthermore, the cohort with BMI ≥ 35 had worse baseline patient-reported outcomes including visual analog scale (VAS) back (7.6 ± 2.3 vs 6.5 ± 2.8, p < 0.001) and leg (7.1 ± 2.6 vs 6.4 ± 2.9, p = 0.031) pain, disability measured by the Oswestry Disability Index (ODI) (53.7 ± 15.7 vs 44.8 ± 17.0, p < 0.001), and quality of life on EuroQol-5D (EQ-5D) questionnaire (0.47 ± 0.22 vs 0.56 ± 0.22, p < 0.001). Patients with BMI ≥ 35 were more likely to undergo fu...