title: A Comparative Cohort Study of Lumbar Microdiscectomy in Obese and Nonobese Patients.
abstract: METHODS
  Prospective comparative cohort study.
  
  
  OBJECTIVE
  Investigate whether there is a difference in postoperative pain reduction, complication rate, and other markers of operative difficulty in obese and nonobese patients undergoing elective lumbar microdiscectomy by a single spinal surgeon.
  
  
  BACKGROUND
  Lumbar radiculopathy is a debilitating condition that affects obese and nonobese patients. There is reluctance among some surgeons to perform lumbar microdiscectomy in the obese population.
  
  
  METHODS
  Over 3 years a group of 34 obese patients were compared with 34 nonobese patients from the same period. Operative duration, blood loss, unintentional durotomies, infection rate, hospital stay, and pain reduction were compared.
  
  
  RESULTS
  Reduction in total pain (control, -82%; obese, -71%) and radicular leg pain (control, -98%; obese, -97%) were similar. The risk of superficial infections was greater in the obese group, but there was no difference in rate of serious complication in our small series. Operative duration was much longer in the obese group (control, 28 min; obese, 70 min), as was total hospital stay.
  
  
  CONCLUSIONS
  We found good postoperative pain relief in both groups. There was no difference in radicular leg pain between obese and nonobese patients but total pain due to lumbago was greater preoperatively and postoperatively in the obese group making their total pain greater. There was no evidence of higher serious complication rate that would preclude offering operative lumbar microdiscectomy to obese patients due to their obesity alone. However, operative duration was significantly longer in obese patients and should be considered accordingly.
authors.affiliation: *Guy's Hospital, London †Walton Centre Neurology & Neurosurgery, Liverpool, UK.
authors.forename: Bahram
authors.initials: B
authors.lastname: Fakouri
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Stovell
authors.forename: Richard
authors.initials: R
authors.lastname: Allom
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D015331:Cohort Studies; D017586:Diskectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D017116:Low Back Pain / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D010146:Pain / Q000209:etiology; D010149:Postoperative Pain / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D011446:Prospective Studies; D011843:Radiculopathy / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult