Comparison of perioperative outcomes in obese and non-obese patients subjected to open lumbar spine surgery




Parménides Guadarrama-Ortiz, Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, Mexico
César O. Ruiz-Rivero, Departamento de Neurocirugía, Centro Especializado en Neurocirugía y Neurociencias México, Ciudad de México, México
Deyanira Capi-Casillas, Programa de Servicio Social en Investigación, Centro Especializado en Neurocirugía y Neurociencias México, Ciudad de México, México
Alondra Román-Villagómez, Programa de Servicio Social en Investigación, Centro Especializado en Neurocirugía y Neurociencias México, Ciudad de México, México
Ulises Palacios-Zúñiga, Department of Neurosurgery, Spine Surgery Service, Hospital Regional 1° de Octubre, ISSSTE, Mexico City, Mexico
Ángel D. Prieto-Rivera, Departamento de Neurocirugía, Centro Especializado en Neurocirugía y Neurociencias México, Ciudad de México, México
José A. Choreño-Parra, Coordinación de Investigación, Centro Especializado en Neurocirugía y Neurociencias México, Ciudad de México. México


Objective: Obesity is a global epidemic affecting developing countries. The relationship between obesity and perioperative outcomes during elective lumbar spine surgery remains controversial, especially in those without morbid disease. Materials and methods: We retrospectively revised the medical records of patients with lumbar spine degeneration subjected to elective surgery. The data retrieved included demographic and clinical characteristics, body mass index (BMI), obesity status (BMI ≥ 30), surgical interventions, estimated blood loss (EBL), operative time, length of stay (LOS), and postoperative complications. Perioperative outcomes were compared between Grade I-II obese and non-obese individuals. Results: We enrolled 53 patients, 18 with Grade I-II obesity. Their median age was 51, with no differences in gender, comorbidities, laboratory parameters, and surgical procedures received between groups. No clinically relevant differences were found between grade I-II obese and non-obese participants in EBL (300 mL vs. 250 mL, p = 0.069), operative time (3.2 h vs. 3.0 h, p = 0.037), and LOS (6 days vs. 5 days, p = 0.3). Furthermore, BMI was not associated with the incidence of significant bleeding and long stay but showed a modest correlation with operative time. Conclusion: Grade I-II obesity does not increase surgical complexity nor perioperative complications during open lumbar spine surgery.



Keywords: Obesity. Body mass index. Spine surgery. Lumbar decompression and fusion. Transforaminal lumbar interbody fusion.