title: Weight Change and Clinical Outcomes Following Adult Spinal Deformity Surgery in Overweight and Obese Patients.
abstract: METHODS
  Retrospective comparative study.
  
  
  BACKGROUND
  The effect of spine surgery on postoperative weight loss or weight gain in overweight and obese spinal deformity patients is unknown.
  
  
  OBJECTIVE
  To evaluate the postoperative outcomes and weight changes in adult patients undergoing spinal deformity surgery.
  
  
  METHODS
  A total of 104 adult patients undergoing primary spinal deformity surgery were enrolled. All patients had a minimum 2-year follow-up (average, 50.1 months). Preoperative and latest follow-up, body mass index (BMI), Oswestry Disability Index, Scoliosis Research Society (SRS)-22 self-image and SRS outcomes scores were collected. Instrumented levels, estimated blood loss, major and minor complications, length of hospitalization, and hospital discharge status were also reviewed and compared.
  
  
  RESULTS
  A total of 66 patients were overweight (BMI > 25-29.9; average, 26.9) (Group OW), whereas 38 patients were obese (BMI > 30; average, 33.5) (Group OB). The average age was 54.5 in Group OW and 48.6 in Group OB (p < .01). Postoperatively, significant changes were not found in the BMI for Group OW, 27.2 (26.9-27.2; p < .39), and for Group OB, 35 (33.5-35; p < .06). Postoperatively, significant improvements were seen in both groups for Oswestry Disability Index (36.1-21.8, Group OW; 44.1-24.4, Group OB; p <.001), SRS self-image (2.9-3.7, Group OW; 2.6-3.8, Group OB; p < .001) and SRS score (3.1-3.8, Group OW; 2.9-3.8, Group OB; p < .001). There were no significant differences in complications between groups.
  
  
  CONCLUSIONS
  As a group, overweight and obese primary spinal deformity patients did not demonstrate significant weight gain or weight loss from preoperative to latest follow-up. However, both overweight and obese patients had significant improvements in outcome scores at latest follow-up and equivalent rates of complications.
authors.affiliation: Department of Orthopaedic Surgery, Washington University in St. Louis, 660 S Euclid Avenue, Campus Box 8233, Saint Louis, MO 63110, USA.
authors.forename: Addisu
authors.initials: A
authors.lastname: Mesfin
authors.affiliation: Department of Orthopaedic Surgery, Washington University in St. Louis, 660 S Euclid Avenue, Campus Box 8233, Saint Louis, MO 63110, USA. Electronic address: lenkel@wudosis.wustl.edu.
authors.forename: Lawrence G
authors.initials: LG
authors.lastname: Lenke
authors.affiliation: Department of Orthopaedic Surgery, Washington University in St. Louis, 660 S Euclid Avenue, Campus Box 8233, Saint Louis, MO 63110, USA.
authors.forename: Keith H
authors.initials: KH
authors.lastname: Bridwell
authors.affiliation: Department of Orthopaedic Surgery, Washington University in St. Louis, 660 S Euclid Avenue, Campus Box 8233, Saint Louis, MO 63110, USA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Jupitz
authors.affiliation: Department of Orthopaedic Surgery, Washington University in St. Louis, 660 S Euclid Avenue, Campus Box 8233, Saint Louis, MO 63110, USA.
authors.forename: Usman
authors.initials: U
authors.lastname: Akhtar
authors.affiliation: Department of Orthopaedic Surgery, Washington University in St. Louis, 660 S Euclid Avenue, Campus Box 8233, Saint Louis, MO 63110, USA.
authors.forename: Jeremy L
authors.initials: JL
authors.lastname: Fogelson
authors.affiliation: Department of Orthopaedic Surgery, Washington University in St. Louis, 660 S Euclid Avenue, Campus Box 8233, Saint Louis, MO 63110, USA.
authors.forename: Stuart
authors.initials: S
authors.lastname: Hershman
authors.affiliation: Department of Orthopaedic Surgery, Washington University in St. Louis, 660 S Euclid Avenue, Campus Box 8233, Saint Louis, MO 63110, USA.
authors.forename: Han Jo
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Washington University in St. Louis, 660 S Euclid Avenue, Campus Box 8233, Saint Louis, MO 63110, USA.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Koester
keywords: Adult patients; Obese; Outcomes; Overweight; Primary spinal deformity surgery