The effect of surgical weight reduction on functional status in morbidly obese patients with low back pain.
BACKGROUND
Although low back (LBP) pain is not a life-threatening disease, it is a source of significant discomfort and disability and accounts for work absences. It has been shown previously that morbid obesity is associated with increased frequency of LBP and that surgical weight loss improves the symptomatology. However, there are no studies to quantitatively assess the exact degree of functional disability caused by severe obesity and the degree of improvement of LBP that follows weight loss from bariatric surgery.


METHODS
29 morbidly obese candidates for bariatric surgery with LBP, weight 132.5+/-27 (mean+/-SD) kg and BMI 47.2+/-8.8 kg/m2 were examined for their functional status using psychometric instruments specifically designed to objectively assess the patients' complaints. The preoperative scores were measured by a) visual analogue scales (VAS1, VAS2, VAS3), b) Roland-Morris disability questionnaire, c) Oswestry LBP disability questionnaire, and d) Waddell disability index, and were compared with the scores obtained by the same instruments 2 years after vertical banded gastroplasty.


RESULTS
The postoperative weight (92.3+/-19 kg) and BMI (32.9+/-6.3 kg/m2) of the 29 patients were significantly reduced (P<0.001). The improved functional disability scores were statistically significant: a) VAS1 1.59+/-1.86 (mean+/-SD) vs 0.32+/-0.64, P<0.001; b) VAS2 5.5+/-1.97 vs 2.14+/-1.88, P<0.001; c) VAS3 0.77+/-1.11 vs 0.09+/-0.29, P=0.006, d) Roland-Morris 7.89+/-5.11 vs 1.89+/-2.13, P<0.001; e) Oswestry 21.22+/-15.63 vs 5.61+/-7.51, P<0.001; f) Waddell 2.81+/-1.37 vs 0.56+/-0.72, P<0.001.


CONCLUSIONS
Surgical weight loss significantly improves the degree of functional disability of morbidly obese patients suffering from LBP.
Melissas
John
J
Department of Surgical Oncology, Faculty of Medicine, University of Crete, Greece. melissas@med.uoc.gr
Kontakis
George
G
Volakakis
Evaggelos
E
Tsepetis
Theodosis
T
Alegakis
Athanasios
A
Hadjipavlou
Alexander
A
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D049088:Bariatrics; D015992:Body Mass Index; D001835:Body Weight; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D010147:Pain Measurement / Q000379:methods; D011594:Psychometrics; D015431:Weight Loss