Does Greater Body Mass Index Increase the Risk for Revision Procedures Following a Single-Level Minimally Invasive Lumbar Discectomy?. Issue 9 (May 2016)

• Record Type: Journal Article
• Authors: Bohl, Daniel D.; Ahn, Junyoung; Mayo, Benjamin C.; Massel, Dustin H.; Tabaraee, Ehsan; Sershon, Robert A.; Basques, Bryce A.; Singh, Kern
• Is Part Of: Spine. Volume 41:Issue 9(2016)
• Page Start: 816
• Page End: 821
• Publication Date: 2016-05
• Subjects: body mass index -- disc herniation -- lumbar discectomy -- minimally invasive -- obese -- obesity -- overweight -- revision -- single-level minimally invasive -- spine surgery; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000001340
• Languages: English
• ISSNs: 0362-2436

Abstract

Abstract : Study Design: Retrospective analysis of a prospectively maintained surgical registry. Objective: To examine the association between body mass index (BMI) and the risk for undergoing a revision procedure following a single-level minimally invasive (MIS) lumbar discectomy (LD). Summary of Background Data: Studies conflict as to whether greater BMI contributes to recurrent herniation and the need for revision procedures following LD. Patients and surgeons would benefit from knowing whether greater BMI is a risk factor to guide the decision whether to pursue an operative versus non-operative treatment. Methods: Patients undergoing a single-level MIS LD were retrospectively identified in our institution's prospectively maintained surgical registry. BMI was categorized as normal weight (<25 kg/m 2 ), overweight (25–30 kg/m 2 ), obese (30–40 kg/m 2 ), or morbidly obese (≥40 kg/m 2 ). Multivariate analysis was used to test for association with undergoing a revision procedure during the first 2 postoperative years. The model was demographics, comorbidities, and operative level. Results: A total of 226 patients were identified. Of these, 56 (24.8%) were normal weight, 80 (35.4%) were overweight, 66 (29.2%) were obese, and 24 (10.6%) were morbidly obese. A total of 23 patients (10.2%) underwent a revision procedure in the first 2 postoperative years. The 2-year risk for revision procedure was 1.8% for normal weight patients, 12.5% for overweight patients, 9.1% for obese patients, and 25.0% for morbidly obese patients. In the multivariate-adjusted analysis model, BMI category was independently associated with undergoing a revision procedure ( P = 0.038). Conclusion: These findings indicate that greater BMI is an independent risk factor for undergoing a revision procedure following a LD. These findings conflict with recent studies that have found no difference between obese and non-obese patients in regards to risk for recurrent herniation and/or revision procedures. Patients with greater BMI undergoing LD should be informed they could have an elevated risk for revision procedures. Level of Evidence: 4