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Does Greater Body Mass Index Increase the Risk for Revision Procedures Following a Single-Level Minimally Invasive Lumbar Discectomy?
STUDY DESIGN.Retrospective analysis of a prospectively maintained surgical registry. OBJECTIVE.To examine the association between body mass index (BMI) and the risk for undergoing a revision procedure following a single-level minimally invasive (MIS) lumbar discectomy (LD). SUMMARY OF BACKGROUND DAT...
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| Published in: | Spine (Philadelphia, Pa. 1976) Pa. 1976), 2016-05, Vol.41 (9), p.816-821 |
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| container_title | Spine (Philadelphia, Pa. 1976) |
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| creator | Bohl, Daniel D Ahn, Junyoung Mayo, Benjamin C Massel, Dustin H Tabaraee, Ehsan Sershon, Robert A Basques, Bryce A Singh, Kern |
| description | STUDY DESIGN.Retrospective analysis of a prospectively maintained surgical registry.
OBJECTIVE.To examine the association between body mass index (BMI) and the risk for undergoing a revision procedure following a single-level minimally invasive (MIS) lumbar discectomy (LD).
SUMMARY OF BACKGROUND DATA.Studies conflict as to whether greater BMI contributes to recurrent herniation and the need for revision procedures following LD. Patients and surgeons would benefit from knowing whether greater BMI is a risk factor to guide the decision whether to pursue an operative versus non-operative treatment.
METHODS.Patients undergoing a single-level MIS LD were retrospectively identified in our institutionʼs prospectively maintained surgical registry. BMI was categorized as normal weight ( |
| doi_str_mv | 10.1097/BRS.0000000000001340 |
| format | article |
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OBJECTIVE.To examine the association between body mass index (BMI) and the risk for undergoing a revision procedure following a single-level minimally invasive (MIS) lumbar discectomy (LD).
SUMMARY OF BACKGROUND DATA.Studies conflict as to whether greater BMI contributes to recurrent herniation and the need for revision procedures following LD. Patients and surgeons would benefit from knowing whether greater BMI is a risk factor to guide the decision whether to pursue an operative versus non-operative treatment.
METHODS.Patients undergoing a single-level MIS LD were retrospectively identified in our institutionʼs prospectively maintained surgical registry. BMI was categorized as normal weight (<25 kg/m), overweight (25–30 kg/m), obese (30–40 kg/m), or morbidly obese (≥40 kg/m). Multivariate analysis was used to test for association with undergoing a revision procedure during the first 2 postoperative years. The model was demographics, comorbidities, and operative level.
RESULTS.A total of 226 patients were identified. Of these, 56 (24.8%) were normal weight, 80 (35.4%) were overweight, 66 (29.2%) were obese, and 24 (10.6%) were morbidly obese. A total of 23 patients (10.2%) underwent a revision procedure in the first 2 postoperative years. The 2-year risk for revision procedure was 1.8% for normal weight patients, 12.5% for overweight patients, 9.1% for obese patients, and 25.0% for morbidly obese patients. In the multivariate-adjusted analysis model, BMI category was independently associated with undergoing a revision procedure (P = 0.038).
CONCLUSION.These findings indicate that greater BMI is an independent risk factor for undergoing a revision procedure following a LD. These findings conflict with recent studies that have found no difference between obese and non-obese patients in regards to risk for recurrent herniation and/or revision procedures. Patients with greater BMI undergoing LD should be informed they could have an elevated risk for revision procedures.Level of Evidence4</description><identifier>ISSN: 0362-2436</identifier><identifier>EISSN: 1528-1159</identifier><identifier>DOI: 10.1097/BRS.0000000000001340</identifier><identifier>PMID: 27128255</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; Body Mass Index ; Diskectomy - adverse effects ; Diskectomy - trends ; Female ; Humans ; Lumbar Vertebrae - surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures - adverse effects ; Minimally Invasive Surgical Procedures - trends ; Overweight - diagnosis ; Overweight - epidemiology ; Overweight - surgery ; Postoperative Complications - diagnosis ; Postoperative Complications - epidemiology ; Prospective Studies ; Reoperation - trends ; Retrospective Studies ; Risk Factors</subject><ispartof>Spine (Philadelphia, Pa. 1976), 2016-05, Vol.41 (9), p.816-821</ispartof><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3523-4f30167a8aa3fc9a75d294142ea38e738863364294e47ff84daa28b7882d93da3</citedby><cites>FETCH-LOGICAL-c3523-4f30167a8aa3fc9a75d294142ea38e738863364294e47ff84daa28b7882d93da3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27128255$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bohl, Daniel D</creatorcontrib><creatorcontrib>Ahn, Junyoung</creatorcontrib><creatorcontrib>Mayo, Benjamin C</creatorcontrib><creatorcontrib>Massel, Dustin H</creatorcontrib><creatorcontrib>Tabaraee, Ehsan</creatorcontrib><creatorcontrib>Sershon, Robert A</creatorcontrib><creatorcontrib>Basques, Bryce A</creatorcontrib><creatorcontrib>Singh, Kern</creatorcontrib><title>Does Greater Body Mass Index Increase the Risk for Revision Procedures Following a Single-Level Minimally Invasive Lumbar Discectomy?</title><title>Spine (Philadelphia, Pa. 1976)</title><addtitle>Spine (Phila Pa 1976)</addtitle><description>STUDY DESIGN.Retrospective analysis of a prospectively maintained surgical registry.
OBJECTIVE.To examine the association between body mass index (BMI) and the risk for undergoing a revision procedure following a single-level minimally invasive (MIS) lumbar discectomy (LD).
SUMMARY OF BACKGROUND DATA.Studies conflict as to whether greater BMI contributes to recurrent herniation and the need for revision procedures following LD. Patients and surgeons would benefit from knowing whether greater BMI is a risk factor to guide the decision whether to pursue an operative versus non-operative treatment.
METHODS.Patients undergoing a single-level MIS LD were retrospectively identified in our institutionʼs prospectively maintained surgical registry. BMI was categorized as normal weight (<25 kg/m), overweight (25–30 kg/m), obese (30–40 kg/m), or morbidly obese (≥40 kg/m). Multivariate analysis was used to test for association with undergoing a revision procedure during the first 2 postoperative years. The model was demographics, comorbidities, and operative level.
RESULTS.A total of 226 patients were identified. Of these, 56 (24.8%) were normal weight, 80 (35.4%) were overweight, 66 (29.2%) were obese, and 24 (10.6%) were morbidly obese. A total of 23 patients (10.2%) underwent a revision procedure in the first 2 postoperative years. The 2-year risk for revision procedure was 1.8% for normal weight patients, 12.5% for overweight patients, 9.1% for obese patients, and 25.0% for morbidly obese patients. In the multivariate-adjusted analysis model, BMI category was independently associated with undergoing a revision procedure (P = 0.038).
CONCLUSION.These findings indicate that greater BMI is an independent risk factor for undergoing a revision procedure following a LD. These findings conflict with recent studies that have found no difference between obese and non-obese patients in regards to risk for recurrent herniation and/or revision procedures. Patients with greater BMI undergoing LD should be informed they could have an elevated risk for revision procedures.Level of Evidence4</description><subject>Adult</subject><subject>Body Mass Index</subject><subject>Diskectomy - adverse effects</subject><subject>Diskectomy - trends</subject><subject>Female</subject><subject>Humans</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - adverse effects</subject><subject>Minimally Invasive Surgical Procedures - trends</subject><subject>Overweight - diagnosis</subject><subject>Overweight - epidemiology</subject><subject>Overweight - surgery</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prospective Studies</subject><subject>Reoperation - trends</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><issn>0362-2436</issn><issn>1528-1159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNpdkc9u1DAQxi0EokvhDRDykUuK7bFj54RoS0ulrUBbOEezyYQNdeLWTnbZB-C9cWn5I3zwSONvfuOZj7GXUhxJUdk3x6urI_HPkaDFI7aQRrlCSlM9ZgsBpSqUhvKAPUvpWxaVIKun7EBZqZwyZsF-nAZK_DwSThT5cWj3_BJT4hdjS9_z3eSXRHzaEF_16Zp3IfIVbfvUh5F_iqGhdo6ZcBa8D7t-_MqRX-XgqVjSljy_7Md-QO_3GbbF1G-JL-dhjZGf9qmhZgrD_u1z9qRDn-jFQzxkX87efz75UCw_nl-cvFsWDRgFhe5AyNKiQ4SuqdCaVlVaakUIjiw4VwKUOudI265zukVUbm2dU20FLcIhe33PvYnhdqY01cPdJ7zHkcKcammdsQZKabNU30ubGFKK1NU3MQ8S97UU9Z0BdTag_t-AXPbqocO8Hqj9U_R743-5u-DzytO1n3cU6w2hnza_eLaE7FoeVBghRZEzCuAnYLiQgA</recordid><startdate>201605</startdate><enddate>201605</enddate><creator>Bohl, Daniel D</creator><creator>Ahn, Junyoung</creator><creator>Mayo, Benjamin C</creator><creator>Massel, Dustin H</creator><creator>Tabaraee, Ehsan</creator><creator>Sershon, Robert A</creator><creator>Basques, Bryce A</creator><creator>Singh, Kern</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201605</creationdate><title>Does Greater Body Mass Index Increase the Risk for Revision Procedures Following a Single-Level Minimally Invasive Lumbar Discectomy?</title><author>Bohl, Daniel D ; Ahn, Junyoung ; Mayo, Benjamin C ; Massel, Dustin H ; Tabaraee, Ehsan ; Sershon, Robert A ; Basques, Bryce A ; Singh, Kern</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3523-4f30167a8aa3fc9a75d294142ea38e738863364294e47ff84daa28b7882d93da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Body Mass Index</topic><topic>Diskectomy - adverse effects</topic><topic>Diskectomy - trends</topic><topic>Female</topic><topic>Humans</topic><topic>Lumbar Vertebrae - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgical Procedures - adverse effects</topic><topic>Minimally Invasive Surgical Procedures - trends</topic><topic>Overweight - diagnosis</topic><topic>Overweight - epidemiology</topic><topic>Overweight - surgery</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prospective Studies</topic><topic>Reoperation - trends</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bohl, Daniel D</creatorcontrib><creatorcontrib>Ahn, Junyoung</creatorcontrib><creatorcontrib>Mayo, Benjamin C</creatorcontrib><creatorcontrib>Massel, Dustin H</creatorcontrib><creatorcontrib>Tabaraee, Ehsan</creatorcontrib><creatorcontrib>Sershon, Robert A</creatorcontrib><creatorcontrib>Basques, Bryce A</creatorcontrib><creatorcontrib>Singh, Kern</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bohl, Daniel D</au><au>Ahn, Junyoung</au><au>Mayo, Benjamin C</au><au>Massel, Dustin H</au><au>Tabaraee, Ehsan</au><au>Sershon, Robert A</au><au>Basques, Bryce A</au><au>Singh, Kern</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does Greater Body Mass Index Increase the Risk for Revision Procedures Following a Single-Level Minimally Invasive Lumbar Discectomy?</atitle><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle><addtitle>Spine (Phila Pa 1976)</addtitle><date>2016-05</date><risdate>2016</risdate><volume>41</volume><issue>9</issue><spage>816</spage><epage>821</epage><pages>816-821</pages><issn>0362-2436</issn><eissn>1528-1159</eissn><abstract>STUDY DESIGN.Retrospective analysis of a prospectively maintained surgical registry.
OBJECTIVE.To examine the association between body mass index (BMI) and the risk for undergoing a revision procedure following a single-level minimally invasive (MIS) lumbar discectomy (LD).
SUMMARY OF BACKGROUND DATA.Studies conflict as to whether greater BMI contributes to recurrent herniation and the need for revision procedures following LD. Patients and surgeons would benefit from knowing whether greater BMI is a risk factor to guide the decision whether to pursue an operative versus non-operative treatment.
METHODS.Patients undergoing a single-level MIS LD were retrospectively identified in our institutionʼs prospectively maintained surgical registry. BMI was categorized as normal weight (<25 kg/m), overweight (25–30 kg/m), obese (30–40 kg/m), or morbidly obese (≥40 kg/m). Multivariate analysis was used to test for association with undergoing a revision procedure during the first 2 postoperative years. The model was demographics, comorbidities, and operative level.
RESULTS.A total of 226 patients were identified. Of these, 56 (24.8%) were normal weight, 80 (35.4%) were overweight, 66 (29.2%) were obese, and 24 (10.6%) were morbidly obese. A total of 23 patients (10.2%) underwent a revision procedure in the first 2 postoperative years. The 2-year risk for revision procedure was 1.8% for normal weight patients, 12.5% for overweight patients, 9.1% for obese patients, and 25.0% for morbidly obese patients. In the multivariate-adjusted analysis model, BMI category was independently associated with undergoing a revision procedure (P = 0.038).
CONCLUSION.These findings indicate that greater BMI is an independent risk factor for undergoing a revision procedure following a LD. These findings conflict with recent studies that have found no difference between obese and non-obese patients in regards to risk for recurrent herniation and/or revision procedures. Patients with greater BMI undergoing LD should be informed they could have an elevated risk for revision procedures.Level of Evidence4</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>27128255</pmid><doi>10.1097/BRS.0000000000001340</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Body Mass Index Diskectomy - adverse effects Diskectomy - trends Female Humans Lumbar Vertebrae - surgery Male Middle Aged Minimally Invasive Surgical Procedures - adverse effects Minimally Invasive Surgical Procedures - trends Overweight - diagnosis Overweight - epidemiology Overweight - surgery Postoperative Complications - diagnosis Postoperative Complications - epidemiology Prospective Studies Reoperation - trends Retrospective Studies Risk Factors |
| title | Does Greater Body Mass Index Increase the Risk for Revision Procedures Following a Single-Level Minimally Invasive Lumbar Discectomy? |
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