title: Outcome of lumbar spinal fusion surgery in obese patients: a systematic review and meta-analysis.
abstract: The aim of this study was to determine whether obesity affects pain, surgical and functional outcomes following lumbar spinal fusion for low back pain (LBP). A systematic literature review and meta-analysis was made of those studies that compared the outcome of lumbar spinal fusion for LBP in obese and non-obese patients. A total of 17 studies were included in the meta-analysis. There was no difference in the pain and functional outcomes. Lumbar spinal fusion in the obese patient resulted in a statistically significantly greater intra-operative blood loss (weighted mean difference: 54.04 ml; 95% confidence interval (CI) 15.08 to 93.00; n = 112; p = 0.007) more complications (odds ratio: 1.91; 95% CI 1.68 to 2.18; n = 43858; p < 0.001) and longer duration of surgery (25.75 mins; 95% CI 15.61 to 35.90; n = 258; p < 0.001). Obese patients have greater intra-operative blood loss, more complications and longer duration of surgery but pain and functional outcome are similar to non-obese patients. Based on these results, obesity is not a contraindication to lumbar spinal fusion.
authors.affiliation: University Hospital Of North Tees and Hartlepool, Stockton on Tees TS19 8PE, UK.
authors.forename: K K
authors.initials: KK
authors.lastname: Lingutla
authors.affiliation: University Hospital Of North Tees and Hartlepool, Stockton on Tees TS19 8PE, UK.
authors.forename: R
authors.initials: R
authors.lastname: Pollock
authors.affiliation: Teesside University, Middlesbrough TS1 3BA, UK.
authors.forename: E
authors.initials: E
authors.lastname: Benomran
authors.affiliation: University Hospital Of North Tees and Hartlepool, Stockton on Tees TS19 8PE, UK.
authors.forename: B
authors.initials: B
authors.lastname: Purushothaman
authors.affiliation: Wansbeck General Hospital, Ashington, NE63 9JJ, UK.
authors.forename: A
authors.initials: A
authors.lastname: Kasis
authors.affiliation: University Hospital Of North Tees and Hartlepool, Stockton on Tees TS19 8PE, UK.
authors.forename: C K
authors.initials: CK
authors.lastname: Bhatia
authors.affiliation: University Hospital Of North Tees and Hartlepool, Stockton on Tees TS19 8PE, UK.
authors.forename: M
authors.initials: M
authors.lastname: Krishna
authors.affiliation: University Hospital Of North Tees and Hartlepool, Stockton on Tees TS19 8PE, UK.
authors.forename: T
authors.initials: T
authors.lastname: Friesem
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D017116:Low Back Pain / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D009765:Obesity / Q000150:complications*; D061646:Operative Time; D010149:Postoperative Pain; D011183:Postoperative Complications; D013123:Spinal Fusion; D016896:Treatment Outcome
keywords: low back pain; lumbar spinal fusion; meta-analysis.; obesity; systematic review