Obesity has an impact on outcome in lumbar disc surgery

ABSTRACTPurposeTo investigate the effect of obesity on outcome in lumbar discectomy.MethodsA cross-sectional postal survey; a self-made questionnaire, Beck depression inventory IA (BDI IA) and the Oswestry low back disability questionnaire (ODI) were sent to the patients, who had undergone lumbar disc surgery in the Oulu University Hospital between June 2005 and May 2008. Patients were divided into three groups according to BMI: normal, pre-obese and obese. The ODI was also examined in the framework of the international classification of functioning, disability and health (ICF) to investigate its ability to describe various dimensions of functioning (body structure and functions, activities and participation).Results The postal survey was sent to 642 patients, of whom 355 (55%) replied. Males dominated in the pre-obese (66%) and obese (62%) groups (p = 0.01). Normal-weighted and pre-obese patients had lower BDI scores compared to obese patients (mean BDI: 8.0, 7.6,11.2, respectively, p = 0.035). Total ODI score was highest in the obese group compared to normal-weighted or pre-obese (20.3,18.6,26.4, respectively, p = 0.011). When ODI was linked to the ICF there were significant differences in all activity domains (mobility, self-care and interpersonal interactions and relationships) and the mobility component of the participation domain between the weight groups.Conclusions and implicationsObesity has an impact on outcome in lumbar discectomy. Obese patients had higher scores in BDI and ODI indicating mild mood disturbances and moderate functional disability. According to ICF, functional disability of obese patients was observed to some extent in all activity domains. Obese patients will be more frequently present for disc surgery and increased morbidity risk must be recognized. We need a strategy to rehabilitate and activate obese patients pre- and postoperatively.

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Depressive symptoms are associated with poor outcome for lumbar spine surgery

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2016.01.008 ◽

2016 ◽

Vol 12 (1) ◽

pp. 13-17 ◽

Cited By ~ 1

Author(s):

Voitto Järvimäki ◽

Hannu Kautiainen ◽

Maija Haanpää ◽

Hannu Koponen ◽

Michael Spalding ◽

...

Keyword(s):

Depressive Symptoms ◽

Lumbar Spine ◽

Spine Surgery ◽

Functional Disability ◽

Pain Medication ◽

Postal Survey ◽

University Hospital ◽

Lumbar Spine Surgery ◽

Cross Sectional ◽

Poor Outcome

AbstractBackground and aimsThe symptoms of pain and depression often present concomitantly, but little is known as to how the different subtypes of depression affect surgical outcome. The aim of this study was to determine whether there is a difference in outcome after lumbar spine surgery between non-depressed patients and patients with different subtypes of depressive symptoms: non-melancholic (NmDS) and melancholic depression (MDS).MethodsThis was a cross-sectional postal survey. A self-made questionnaire, the Beck Depression Inventory (BDI) and the Oswestery Low Back Disability Questionnaire (ODI) were sent to patients who had undergone lumbar spine surgery in the Oulu University Hospital between June, 2005 and May, 2008. BDI ≤ 10 were further classified into NmDS or MDS.ResultsA total of 537 patients (66%) completed the survey. Of these, 361 (67%) underwent disc surgery, 85 (16%) stabilizing surgery and 91 (17%) decompression. Participants were divided into three groups: BDI< 10 N=324 (60%), NmDS N=153 (29%) and MDS N=60 (11%). The mean ODI (SD) in the BDI<1 0 group was 16 (15), in the NmDS group 36 (15), and in the MDS group 41 (18) (p<0.001). The ODI profiles were different between the groups (p<0.001). Pain was more frequent in depressive patients (88% of MDS, 81% in NmDS and 40% in BDI < 10 patients experienced pain, p<0.001). The intensity of pain and pain-related disability was lowest among the patients in the BDI <10 group and highest among the MDS patients. Regular pain medication was used by 87% of patients in the MDS group, 93% of patients in the NmDS group, and 71% of patients in the BDI< 10 group (p<0.001). Response to pain medication with NRS (0–10) was 5.6 among MDS, 5.8 among NmDS and 6.5 among BDI< 10 patients (p<0.001).ConclusionDifferent types of depressive symptoms are associated with poor outcome after lumbar spine surgery. The outcome was worst in patients suffering from the MDS subtype. This was observed in pain intensity, functional disability and response to pain medication.ImplicationIt would be important to evaluate depression pre- and postoperatively. Offering a tailored rehabilitation programme to MDS patients should be considered.© 2016 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

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Challenges in the Analysis of Longitudinal Pain Data: Practical Lessons from a Randomized Trial of Annular Closure in Lumbar Disc Surgery

Pain Research and Treatment ◽

10.1155/2019/3498603 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Gerrit J. Bouma ◽

Martin Barth ◽

Larry E. Miller ◽

Sandro Eustacchio ◽

Charlotte Flüh ◽

...

Keyword(s):

Lumbar Disc ◽

Lumbar Discectomy ◽

Pain Severity ◽

Leg Pain ◽

Lumbar Disc Surgery ◽

Integrated Analysis ◽

Pain Scores ◽

Disc Surgery ◽

Unadjusted Analysis

Purpose. To analyze leg pain severity data from a randomized controlled trial (RCT) of lumbar disc surgery using integrated approaches that adjust pain scores collected at scheduled follow-up visits for confounding clinical events occurring between visits. Methods. Data were derived from an RCT of a bone-anchored annular closure device (ACD) following lumbar discectomy versus lumbar discectomy alone (Control) in patients with large postsurgical annular defects. Leg pain was recorded on a 0 to 100 scale at 6 weeks, 3 months, 6 months, 1 year, and 2 years of follow-up. Patients with pain reduction ≥20 points relative to baseline were considered responders. Unadjusted analyses utilized pain scores reported at follow-up visits. Since symptomatic reherniation signifies clinical failure of lumbar discectomy, integrated analyses adjusted pain scores following a symptomatic reherniation by baseline observation carried forward for continuous data or classification as nonresponders for categorical data. Results. Among 550 patients (272 ACD, 278 Control), symptomatic reherniation occurred in 10.3% of ACD patients and in 21.9% of controls (p < 0.001) through 2 years. There was no difference in leg pain scores at the 2-year visit between ACD and controls (12 versus 14; p = 0.33) in unadjusted analyses, but statistically significant differences favoring ACD (19 versus 29; p < 0.001) in integrated analyses. Unadjusted nonresponder rates were 6.0% with ACD and 6.7% with controls (p = 0.89), but 15.7% and 27.8% (p = 0.001) in integrated analyses. The probability of nonresponse was 16.4% with ACD and 18.3% with controls (p = 0.51) in unadjusted analysis, and 23.7% and 31.2% (p = 0.04) in integrated analyses. Conclusion. In an RCT of lumbar disc surgery, an integrated analysis of pain severity that adjusted for the confounding effects of clinical failures occurring between follow-up visits resulted in different conclusions compared to an unadjusted analysis of pain scores reported at follow-up visits only.

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The Effect of Lumbar Disc Surgery on Postoperative Pulmonary Function and Temperature-A Comparison Study of Microsurgical Lumbar Discectomy with Standard Lumbar Discectomy

Spine ◽

10.1097/00007632-199302000-00019 ◽

1993 ◽

Vol 18 (2) ◽

pp. 287-290 ◽

Cited By ~ 10

Author(s):

Robert E. Kelly ◽

Miles H. Dinner ◽

Michael H. Lavyne ◽

David W. Andrews

Keyword(s):

Pulmonary Function ◽

Lumbar Disc ◽

Lumbar Discectomy ◽

Lumbar Disc Surgery ◽

Comparison Study ◽

Postoperative Pulmonary Function ◽

Disc Surgery

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Manipulative rehabilitation applied soon after lumbar disc surgery improves late post-operative functional disability: A preliminary 2-year follow-up study

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-169546 ◽

2017 ◽

Vol 30 (5) ◽

pp. 999-1004 ◽

Cited By ~ 2

Author(s):

Byungho J. Kim ◽

Taeyeong Kim ◽

Junghoon Ahn ◽

Heecheol Cho ◽

Dongyun Kim ◽

...

Keyword(s):

Functional Disability ◽

Lumbar Disc ◽

Lumbar Disc Surgery ◽

Follow Up Study ◽

Disc Surgery

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EFFICACY OF ANTIBIOTICS PROPHYLAXIS IN PATIENTS WITH LUMBAR DISC HERNIATION UNDERGOING LUMBAR DISCETOMY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.5.2 ◽

2018 ◽

Vol 8 (5) ◽

pp. 14-19

Author(s):

Tri Truong Van ◽

Tri Tran Duc Duy ◽

Khai Vo Le Quang

Keyword(s):

Surgical Site Infection ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Lumbar Discectomy ◽

University Hospital ◽

Site Infection ◽

Surgical Wound ◽

A Prospective Study ◽

Length Of Hospitalization

Introduction: Surgical wound infection in developing coutries is about 3%. Antibiotics prophylaxis may help to reduce the surgical site infection. The objective of this study was to evaluate the efficacy of antibiotics prophylaxis in patients with lumbar disc herniation who were treated with lumbar discectomy at Hue University hospital. Materials and Methods: A prospective study was conducted at Hue University hospital from March 2015 to May 2018 on 54 patients with lumbar disc herniation who were used antibiotics prophylaxis when undergoing discectomy. Results: The infection rate in our study was 0%. Antibiotics prophylaxis reduced the length of hospitalization as well as the medical cost. Conclusion: Antibiotics prophylaxis was effective in preventing surgical site infection despite the fact that the condition of operating rooms did not meet the standard rules. Key words: prophylaxis antibiotics, lumbar disc herniation

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POS1281 HOW DOES OBESITY INFLUENCE THE FEATURES OF KNEE OSTEOARTHRITIS?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3602 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 923.4-924

Author(s):

H. Hachfi ◽

D. Khalifa ◽

M. Brahem ◽

N. Ben Chekaya ◽

M. Younes

Keyword(s):

Knee Osteoarthritis ◽

Functional Impairment ◽

Statistical Significance ◽

Obese Group ◽

University Hospital ◽

Obese Patients ◽

Cross Sectional ◽

Duration Of Symptoms ◽

Lequesne Index ◽

The Mean

Background:Knee osteoarthritis and obesity are both major health problems. It is now admitted that the prevalence of knee osteoarthritis gets higher with obesity and that weight loss helps knee function and allows patients to avoid surgery.Objectives:The aim of this study was to study the influence of obesity on knee osteoarthritis features.Methods:A cross-sectional study was conducted in the university hospital Taher Sfar of Tunisia over a period of 6 months. Patients who had knee osteoarthritis confirmed by radiographs were included. Sociodemographic, clinical, radiological and therapeutic data were collected from medical records and visits. Obesity was defined by a body mass index (BMI) ≥30. Functional impairment was assessed by the Womac index and Lequesne index.Results:The study included 186 patients. There were 31 males and 155 femmes. The mean age was 60±10 years. The percentage of obese patients was 53,8%. The mean age was similar in both groups obese and non obese. There were more women in the obese group compared to the non obese group (p=0.0001), more patients who had diabetes mellitus and dyslipidemia (p=0.002). Non-obese patients had a shorter duration of symptoms with no statistical significance (p=0.151). Obese patients had more involvement of both knees (p<0.0001). Obesity did not have an impact on pain severity. Severity of radiological images (p=0,0001) were more frequent in obese patients. Functional impairment was similar in both groups. However, the percentage of patients having a very important functional impairment with Lequesne index was higher in obese patients (p<0.029). Obese patients also needed more physical therapy sessions (p=0.035).Conclusion:Knee osteoarthritis in obese patients is characterized with the femlae gender predominance, bilateral knee involvement, and a more severe images on radiographs. Thus the need for better control of weight and the importance of physical activity.References:[1]Coggon D, Reading I, Croft P, et al. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord J Int Assoc Study Obes 2001; 25: 622–627.Disclosure of Interests:None declared

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