Minimally Invasive Posterior Lumbar Surgery in the Morbidly Obese, Obese and Non-Obese populations: A Single Institution Retrospective Review

OBJECTIVE The effect of obesity on outcomes in minimally invasive surgery (MIS) approaches to posterior lumbar surgery is not well characterized. The authors aimed to determine if there was a difference in operative variables and complication rates in obese patients who underwent MIS versus open approaches in posterior spinal surgery, as well as between obese and nonobese patients undergoing MIS approaches. METHODS A retrospective review of all consecutive patients who underwent posterior lumbar surgery from 2013 to 2016 at a single institution was performed. The primary outcome measure was postoperative complications. Secondary outcome measures included estimated blood loss (EBL), operative time, the need for revision, and hospital length of stay (LOS); readmission and disposition were also reviewed. Obese patients who underwent MIS were compared with those who underwent an open approach. Additionally, obese patients who underwent an MIS approach were compared with nonobese patients. Bivariate and multivariate analyses were carried out between the groups. RESULTS In total, 423 obese patients (57.0% decompression and 43.0% fusion) underwent posterior lumbar MIS. When compared with 229 obese patients (56.8% decompression and 43.2% fusion) who underwent an open approach, patients in both the obese and nonobese groups who underwent MIS experienced significantly decreased EBL, LOS, operative time, and surgical site infections (SSIs). Of the nonobese patients, 538 (58.4% decompression and 41.6% fusion) underwent MIS procedures. When compared with nonobese patients, obese patients who underwent MIS procedures had significantly increased LOS, EBL, operative time, revision rates, complications, and readmissions in the decompression group. In the fusion group, only LOS and disposition were significantly different. CONCLUSIONS Obese patients have poorer outcomes after posterior lumbar MIS when compared with nonobese patients. The use of an MIS technique can be of benefit, as it decreased EBL, operative time, LOS, and SSIs for posterior decompression with or without instrumented fusion in obese patients.

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Faculty Opinions recommendation of Minimally Invasive Surgery in Morbidly Obese Women.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.737043468.793570312 ◽

2020 ◽

Author(s):

Eva Chalas

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Morbidly Obese ◽

Obese Women

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Incidence and clinical characteristics of nonmelanoma skin cancers among Hispanic and Asian patients in the US: A 5-year, single institution retrospective review

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2015.02.757 ◽

2015 ◽

Vol 72 (5) ◽

pp. AB186

Keyword(s):

Retrospective Review ◽

Clinical Characteristics ◽

Single Institution ◽

Asian Patients ◽

Skin Cancers ◽

The Us ◽

Nonmelanoma Skin Cancers

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Amyloid in the Breast: Retrospective Review with Clinic‐Pathologic and Radiologic Correlation of 32 Cases from a Single Institution

Histopathology ◽

10.1111/his.14329 ◽

2021 ◽

Author(s):

Lauren A. Duckworth ◽

Claudiu V. Cotta ◽

J Jordi Rowe ◽

Erinn Downs‐Kelly ◽

Miglena K. Komforti

Keyword(s):

Retrospective Review ◽

Single Institution

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Endovascular Bariatric Surgery as Novel Minimally Invasive Technique for Weight Management in the Morbidly Obese: Review of the Literature

Nutrients ◽

10.3390/nu13082541 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2541

Author(s):

Giuseppe Massimo Sangiorgi ◽

Alberto Cereda ◽

Nicola Porchetta ◽

Daniela Benedetto ◽

Andrea Matteucci ◽

...

Keyword(s):

Bariatric Surgery ◽

Minimally Invasive ◽

Weight Management ◽

World Health ◽

Invasive Technique ◽

Morbidly Obese ◽

World Population ◽

Obese Patients ◽

The World ◽

Open Bariatric Surgery

Nowadays, obesity represents one of the most unresolved global pandemics, posing a critical health issue in developed countries. According to the World Health Organization, its prevalence has tripled since 1975, reaching a prevalence of 13% of the world population in 2016. Indeed, as obesity increases worldwide, novel strategies to fight this condition are of the utmost importance to reduce obese-related morbidity and overall mortality related to its complications. Early experimental and initial clinical data have suggested that endovascular bariatric surgery (EBS) may be a promising technique to reduce weight and hormonal imbalance in the obese population. Compared to open bariatric surgery and minimally invasive surgery (MIS), EBS is much less invasive, well tolerated, with a shorter recovery time, and is probably cost-saving. However, there are still several technical aspects to investigate before EBS can be routinely offered to all obese patients. Further prospective studies and eventually a randomized trial comparing open bariatric surgery vs. EBS are needed, powered for clinically relevant outcomes, and with adequate follow-up. Yet, EBS may already appear as an appealing alternative treatment for weight management and cardiovascular prevention in morbidly obese patients at high surgical risk.

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