Influence of Obesity on Access-Related Complications During Anterior Lumbar Spine Interbody Fusion

The anterior lumbar spine approach has gained in popularity in recent years, but the associated access-related complications for obese patients have not been clearly established. This study aimed to analyze the relationship between obesity or overweight and the safety of the anterior lumbar spine approach.

Eighty-four consecutive patients admitted for lumbar spine surgery by anterior approach between 2011 and 2014 were included. The surgical approach consisted of left lateral minilaparotomy and retroperitoneal dissection. The patients were categorized into 3 different groups according to their body mass index (BMI). The studied outcomes measures included medical history, BMI, the number of fused levels, surgery duration, blood loss, vascular injury, day of discharge, surgical revision, and wound infection.

No significant difference was found across the BMI groups with regard to vascular or infectious complications. The duration of surgery was significantly higher in the obese group.

Because BMI does not seem to increase the overall risk of complications, the anterior lumbar spine approach should be considered in obese or overweight patients, as in nonoverweight patients.