gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

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Influence of obesity on posterior lumbar interbody fusion

Der Einfluss der Adipositas auf die Posterior Lumbar Interbody Fusion (PLIF)

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  • corresponding author T. Kombos - Neurochirurgische Klinik, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin
  • F. Bode - Neurochirurgische Klinik, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin
  • O. Suess - Neurochirurgische Klinik, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin
  • M. Brock - Neurochirurgische Klinik, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 12.194

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc411.shtml

Published: May 8, 2006

© 2006 Kombos et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Posterior lumbar interbody fusion (PLIF) with cages and transpedicular stabilization is a routine method for the treatment of spondylolisthesis. However, controversy does exist on whether obese patients should be treated with this method. The purpose of this study was to determine the influence of obesity on the clinical outcome following PLIF surgery.

Methods: In this prospective study 72 patients were included. Patients were divided into two groups: Group A: patients with Body Mass Index (BMI) less than 25 and Group B: with BMI greater than 25. Patients were evaluated according to their clinical presentation and postoperative outcome. Furthermore, intra- and perioperative complications were noted. In all cases PLIF was performed by Titanium cages and transpedicular fixation. Cage packing was performed with autologous spongiosa. The follow-up period was 36 months.

Results: There were 31 patients included in Group A and 41 in Group B. The mean BMI in Group A was 22,73 and in Group B 30,84. Serious entero-, pulmo- or urological complications in both groups were not observed. Implant failure for pedicle screws was observed in one case of group B. In 4_ cases (4_/31) of Group A minor surgery dependend complications were observed. In Group B there were 20 cases (20/41) with such complications. In 4patients of group B a reoperation was needed whereas in group A these complications were treated conservatively.The mean surgery duration time was 209 minutes in Group A and 232 minutes in Group B. Blood transfusion was not necessary in either group. Preoperative symptoms resulting from a lumbar spinal canal stenosis improved in all cases. All patients were mobilized on the first postoperative day. The mean hospitalization time was 15,5 days in Group A and 18,9 in Group B.

Conclusions: Obesity is a disease that affects nearly one-third of the adult population in western countries. Spondylolisthesis leads to low back pain with radicular pain which typically increases during physical work. The combination between obesity and spondylolisthesis deserves special concideration. No data are available about the clinical course and the complication rate in this group of patients. According to the results presented here a statistical significant higher rate for perioperative complications is observed in the presence of obesity. However, these patients do profit from surgery with improvement of pain and therefore quality of life so that obesity as such does not state a contraindication for PLIF.