Comparison and investigation of complications after lumbar spine fusion and non-fusion surgeries in obese and non-obese patients

Abstract

According to the studies, the effect of obesity on the results of spine surgery is controversial and the studies presented different and contradictory results, and the risk of pseudarthrosis after fusion surgery has not been investigated, and surgeons are increasingly reluctant to perform surgery in Patients who have a higher body mass index refuse, so in this study we compared the rate of complications (deep vein thrombosis, nerve deficit, risk of pseudarthrosis and pain) and the outcomes after fusion and non-fusion surgery between obese and non-obese groups of patients. Materials and Methods: The current study is a retrospective study of all patients who underwent lumbar spine surgery between 2019 and 2018 as a census in Imam Reza Hospital. Information about complications (infection, deep vein thrombosis, nerve deficits and pain) and intraoperative outcomes (bleeding, CSF leakage) of fusion and non-fusion surgery were collected from patients' files. Information about BMI is also extracted. Patients are classified as obese if their BMI is equal to or greater than 30 kg/m2 and less than 30 kg/m2 (non-obese). Other variables analyzed in this study include age, gender, blood loss and operation time, length of hospitalization and patient satisfaction. Results: Bleeding was lowest in the non-obese group with non-fusion surgery (P=0.035) and more in obese patients with fusion (P=0.027) without fusion (P=0.01); Also, CSF leakage was more in obese patients with fusion surgery (P=0.05) and compared to obese patients with non-fusion surgery, there was no significant difference (P=0.32). No neurological deficit was observed in any of the patients, and the rate of infection was higher in obese group patients undergoing luminal fusion compared to non-obese group patients with and without fusion (P=0.05); The risk of pseudarthrosis was higher in patients of the obese group undergoing fusion surgery compared to other patients (P=0.05); Patients in the obese group undergoing luminal fusion surgery had a longer hospitalization period than patients in the non-obese group undergoing luminal fusion surgery (P=0.05) and also a significant difference was observed between the groups (P=0.05) (p=0/03).