title: Does obesity affect surgical outcomes in degenerative scoliosis?
abstract: METHODS
  Retrospective cohort analysis of prospectively collected data.
  
  
  OBJECTIVE
  To determine whether an association exists between body mass and surgical outcomes in patients with degenerative scoliosis after long instrumented spinal arthrodesis (≥ 4 discs).
  
  
  BACKGROUND
  Obesity is thought to be associated with increased surgical complications and inferior clinical outcomes in adults. There are no studies analyzing the effect of obesity on surgical outcomes in patients with degenerative scoliosis after long instrumented spinal arthrodesis.
  
  
  METHODS
  Eighty-four consecutive patients with degenerative scoliosis (69 females and 15 males; mean age, 68.6 ± 8.0 yr) with a minimum follow-up of 2 years were included in this study. Patients were divided into 3 groups according to body mass index (BMI): obese (BMI ≥ 30 kg/m², n = 19), overweight (BMI = 25-29.9 kg/m², n = 35), and normal weight (BMI < 25 kg/m², n = 30). Radiographical measures, Oswestry Disability Index, visual analogue scale score, as well as comorbidities and complications were reviewed and analyzed for all patients preoperatively and at 1- and 2-year follow-ups.
  
  
  RESULTS
  Compared with the normal weight group, no significant differences in surgical methods, comorbidities, complication rates, curve correction, or radiographical measures were found in the obese and overweight groups, except for a greater preoperative lumbar lordosis in the overweight group (-40.3° ± 13.8° vs. -26.0° ± 18.9°, P < 0.05). At 2-year follow-up, Oswestry Disability Index and visual analogue scalescores improved significantly in all groups compared with preoperatively (P < 0.01). The changes of Oswestry Disability Index and visual analogue scalescores from preoperatively to final follow-up were similar in the 3 groups (P > 0.05).
  
  
  CONCLUSIONS
  Obesity did not affect the amount of deformity correction and did not increase comorbidities and postoperative complication rates. Overweight patients had a greater lumbar lordosis before surgery than normal weight patients. Obese and overweight patients benefited from surgery just as much as normal weight patients at 2-year follow-up.
authors.affiliation: *Department of Orthopaedic Surgery, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P. R. China †Sonoran Spine Center, Phoenix, AZ ‡Sonoran Spine Research and Education Foundation, Phoenix, AZ §Banner Good Samaritan Orthopedic Surgery Residency Program, Phoenix, AZ; and ¶Department of Orthopaedic Surgery, University of Arizona, Phoenix, AZ.
authors.forename: Lingjie
authors.initials: L
authors.lastname: Fu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Chang
authors.forename: Dennis G
authors.initials: DG
authors.lastname: Crandall
authors.forename: Jan
authors.initials: J
authors.lastname: Revella
mesh_terms: D000368:Aged; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D056865:Ideal Body Weight; D008141:Lordosis / Q000150:complications; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000009:adverse effects; D016896:Treatment Outcome