Minimally invasive lumbar discectomy in obese patients

To assess patient outcomes and complication rates after minimally invasive lumbar microdiscectomy in an obese patient population.

A retrospective clinical review of 32 patients with a body mass index of 30 kg/m or greater undergoing lumbar minimally invasive discectomy was performed. The initial chart review was followed by phone interview if all information could not be obtained from chart review. Demographic and pertinent pre-, peri-, and postoperative data were obtained.

Favorable clinical outcomes were obtained in all patients except one, indicating that they would undergo operative intervention again. Most patients reported minimal or no leg or back pain. Twenty-five of the patients did not require any chronic analgesia. The overall complication rate was 12.5%. Two patients had recurrent disc herniations requiring reoperation and one patient required fusion for a pars defect and subsequent subluxation.

Lumbar minimally invasive discectomy is our preferred surgical technique for symptomatic disc herniations in this patient population. Decreased incision length and a trend toward reduced infectious complications are the primary reasons. We feel that, given the comorbidities often found in this patient population, a minimally invasive technique will supplant open approaches in the near future.