Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P130. Obese patients may experience worse back pain and less improvement in back pain compared to nonobese patients following lumbar decompression-only surgery

BACKGROUND CONTEXT Obesity is a significant comorbidity that can increase the risk, technical difficulty and outcomes following spine surgery. Recent studies have examined the impact of obesity on outcomes following lumbar degenerative stenosis up to one year after surgery. However, the impact of obesity on longer-term outcomes following lumbar decompression is unclear. PURPOSE The goal of this study was to compare obese and nonobese patients in terms of patient reported outcomes preoperatively and at final follow-up between. STUDY DESIGN/SETTING Retrospective cohort series. PATIENT SAMPLE We performed a retrospective cohort analysis of patients who underwent a primary lumbar laminectomy, discectomy or a combination of the two between 2009 and 2015 by one of two senior orthopedic spine surgeons. Patients were excluded from analysis if they had any previous lumbar surgery, were under 18years of age at the time of surgery or had postoperative follow up less than 3. Patients were considered obese if their BMI was 30 or greater. OUTCOME MEASURES Patient reported outcomes were obtained in the form of Oswestry Disability Index (ODI) scores, Visual Analog Scales (VAS) scores for the back and leg, 12-Item Short Form Mental and Physical Survey (SF-12) scores, and the Veterans Rand 12-Item Health Mental and Physical Survey (VR-12) scores. Patients were also surveyed about their expectations and satisfactions following surgery. METHODS Baseline patient characteristics were compared using chi-squared analysis and independent sample t -tests for categorical and continuous data, respectively. Bivariate and multivariate regressions were subsequently used to compare clinical outcomes between procedure groups. Multivariate analyses controlled for differences in baseline patient characteristics. RESULTS Overall, 325 consecutive patients who fulfilled our inclusion criteria were assessed. Average follow-up was 24.14 months (range 3–78 months). There were 200 patients with a BMI less than 30 and 125 patients with a BMI of 30 or greater (obese group). The obese group contained significantly more patients with a diabetes diagnosis (62.6% vs. 30.7%; p CONCLUSIONS At approximately 2years following lumbardecompression-only surgery, obese patients may expect worse postoperative back pain and less improvement in back pain compared to their nonobese counterparts. Otherwise, other patient reported outcomes appear to reveal similar clinical improvement in mental and physical health following surgery. Reoperation rates are similar between the two groups of patients. Both groups report being satisfied with their outcome with their expectations being met or exceeded. These concerns and the effect of obesity on overall health continue to emphasize the importance of weight discussions and expectations prior to surgery.