Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr;12(3):409-414.
doi: 10.1177/2192568220953393. Epub 2020 Sep 1.

Complications of Spine Surgery in "Super Obese" Patients

Gennadiy A Katsevman  1 , Scott D Daffner  2 , Nicholas J Brandmeir  1 , Sanford E Emery  2 , John C France  2 , Cara L Sedney  1
Affiliations

Complications of Spine Surgery in "Super Obese" Patients

Gennadiy A Katsevman et al. Global Spine J. 2022 Apr.

Abstract

Study design: Retrospective chart review with matched control.

Objective: To evaluate the indications and complications of spine surgery on super obese patients.

Methods: A retrospective review assessed super obese patients undergoing spine surgery at a level-1 trauma and spine referral center from 2012 to 2016. Outcomes were compared to age-matched controls with body mass index (BMI) <50 kg/m2. The control group was further subdivided into patients with BMI <30 kg/m2 (normal) and BMI between 30 and 50 kg/m2 (obese).

Results: Sixty-three super obese patients undergoing 86 surgeries were identified. Sixty patients (78 surgeries) were in the control group. Age and number of elective versus nonelective cases were not significantly different. Mean BMI of the super obese group was 55 kg/m2 (range 50-77 kg/m2) versus 29 kg/m2 in the controls (range 20-49 kg/m2). Fifty-two percent of surgeries were elective, and the most common indication was degenerative disease (39%). Compared with controls, super obese patients had a higher complication rate (30% [n = 19] vs 10% [N = 6], P = .0055) but similar 30-day mortality rate (5% vs 5%), a finding that was upheld when comparing super obese with each of the control group stratifications (BMI 30-50 and BMI <30 kg/m2). The most common complication among super obese patients was wound dehiscence/infection (n = 8, 13%); 2 patients' surgeries were aborted. Complication rates for elective surgery were 21% (n = 7) for super obese patients and 4% (n = 1) for controls (P = .121); complication rates for nonelective procedures were 40% (n = 12) and 14% (n = 5), respectively (P = .023).

Conclusion: The complication rate of spine surgery in super obese patients (BMI ≥ 50 kg/m2) is significantly higher than other patients, particularly for nonelective cases.

Keywords: body mass index (BMI); complications; retrospective review; spine surgery; super obesity.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of obesity among adults and youth: United States, 2011-2014. NCHS Data Brief. 2015;(219):1–8. doi:10.1017/S1368980017000088 - PubMed
    1. Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual medical spending attributable to obesity: payer-and service-specific estimates. Health Aff (Millwood). 2009;28:w822–w831. doi:10.1377/hlthaff.28.5.w822 - PubMed
    1. Epstein NE. More risks and complications for elective spine surgery in morbidly obese patients. Surg Neurol Int. 2017;8:66. doi:10.4103/sni.sni_49_17 - PMC - PubMed
    1. Leboeuf-Yde C, Kyvik KO, Bruun NH. Low back pain and lifestyle. Part II—obesity. Information from a population-based sample of 29 424 twin subjects. Spine (Phila Pa 1976). 1999;24:779–783. - PubMed
    1. Phan K, Kothari P, Lee NJ, Virk S, Kim JS, Cho SK. Impact of obesity on outcomes in adults undergoing elective posterior cervical fusion. Spine (Phila Pa 1976). 2017;42:261–266. doi:10.1097/BRS.0000000000001711 - PubMed

LinkOut - more resources