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Morbidly Obese Patients Have Similar Clinical Outcomes and Recovery Kinetics After Minimally Invasive Decompression.

Pratyush Shahi¹, Tejas Subramanian^1,2, Sumedha Singh¹

¹Hospital for Special Surgery, New York, NY.

|May 17, 2024

Summary

Class 2/3 obesity patients experience worse outcomes after minimally invasive decompression but achieve similar recovery and complication rates as other BMI groups. This study highlights comparable functional improvements and safety profiles, regardless of severe obesity.

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Area of Science:

Spine surgery outcomes
Obesity and health outcomes
Minimally invasive spinal procedures

Background:

Limited research exists on the impact of severe obesity (Class 2/3) on outcomes after minimally invasive decompression.
Understanding these effects is crucial for patient counseling and surgical planning.

Purpose of the Study:

To investigate the influence of Class 2/3 obesity (BMI ≥35) on outcomes following minimally invasive decompression surgery.
To compare outcomes across different body mass index (BMI) categories.

Main Methods:

Retrospective cohort study involving 838 patients undergoing primary minimally invasive decompression.
Patients were stratified into four BMI groups: normal, overweight, Class 1 obesity, and Class 2/3 obesity.
Outcomes assessed included operative variables, patient-reported outcome measures (PROMs), complication rates, and return to activities.

Main Results:

Patients with Class 1 and 2/3 obesity had longer operative times.
Class 2/3 obesity was associated with worse preoperative and postoperative PROMs (ODI, VAS, SF-12 PCS).
Despite initial deficits, Class 2/3 obese patients demonstrated similar improvements in PROMs, functional recovery, and complication rates compared to other groups.

Conclusions:

Class 2/3 obese patients present with poorer preoperative and postoperative patient-reported outcomes.
However, these patients achieve comparable improvements in PROMs, functional recovery, and complication rates after minimally invasive decompression.
The findings suggest that severe obesity does not preclude successful outcomes or increase complication risks in this surgical context.