Poster Presentation Sydney Spinal Symposium 2023

Influence of BMI on disability outcomes in Spinal Endoscopic Surgery: a cohort study (#27)

Froukje Koremans 1 , Kyle Sheldrick 1 , Neha Chopra 1 , Prashanth Rao 2 , Ashish D Diwan 1
  1. Spine Labs, Bondi Beach, NEW SOUTH WALES, Australia
  2. Brain and Spine Surgery, Norwest Private Hospital, Bella Vista, NSW, Australia

Abstract

Study Design: Retrospective case-series study

Objectives: This retrospective study aimed to assess the influence of BMI on the outcomes of endoscopic spinal surgery in a single-centre Neurosurgical practice in Australia, considering obesity as a significant growing global public health concern.

Methods: A total of 98 patients with spinal conditions who underwent endoscopic surgery between August 2021 and January 2022 were included. Patient data, including demographic information, preoperative clinical status, intraoperative details, clinical complications, and postoperative outcomes, were collected from electronic medical records. Surgical outcomes, include, Visual Analogue Scale (VAS) leg pain scores, VAS back pain scores, Oswestry Disability Index (ODI), Roland‐Morris Disability Questionnaire (RMDQ) scores, and the Quality-of-life EuroQol-5 Dimensions Questionnaire (EQ5D) scores, were assessed. Descriptive statistics, Estimation-Stats package, and Spearman’s rank correlations were used for statistical analysis, considering a P-value < 0.05 as statistically significant.

Results: The mean BMI of the patients was 29.72 ± 6.46, with 38.8% categorized as overweight. The analysis revealed significant negative correlations between BMI and Delta-ODI, Delta-RMDQ, and BMI category and Delta-ODI, Delta-RMDQ. Higher BMI categories were associated with less improvement in ODI-scores compared to a shared control. Improvement in ODI-scores was observed for all BMI categories postoperatively.

Conclusion: This study demonstrates that higher BMI is strongly negatively associated with postoperative improvement in disability for patients undergoing endoscopic surgical treatments. These findings emphasize the importance of addressing obesity as a modifiable risk factor to enhance patient outcomes after surgery. Surgeons should set realistic expectations for functional improvement when discussing endoscopic procedures with obese patients.