The Impact of Obesity on Spine Surgery Operative Time: A Quantitative Analysis

Area of Science:

• Spine Surgery
• Surgical Outcomes
• Obesity Research

Background:

• Obesity is a growing concern in spine surgery.
• The impact of obesity on operative time and subsequent complications requires further elucidation.

Purpose of the Study:

• To investigate how obesity (measured by BMI) affects operative time in single-level anterior cervical discectomy and fusion (ACDF) and posterior lumbar fusion (PLF).
• To determine the influence of operative time on wound complications and surgical infections following ACDF and PLF.

Main Methods:

• Retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.
• Inclusion of patients undergoing single-level ACDF or PLF.
• Multivariable regression analysis to assess relationships between BMI, operative time, and complications.

Main Results:

• Each unit increase in BMI correlated with a 0.38-minute increase in ACDF operative time and a 0.84-minute increase in PLF operative time.
• Increased operative time (25th to 75th percentile) raised wound complication probability by 17.1% (ACDF) and 19.7% (PLF).
• Increased operative time raised postoperative infection probability by 30.0% (ACDF) and 12.5% (PLF).

Conclusions:

• Higher BMI leads to a more significant increase in operative time for PLF compared to ACDF.
• Prolonged operative times in both ACDF and PLF increase the likelihood of wound complications and surgical infections.
• This study provides the first quantitative link between obesity and operative time in spine surgery.