• World Neurosurg · Feb 2023

    Review

    Clinical Outcomes of Bariatric Surgery Before Spinal Fusion: A Systematic Review.

    • Dylan Luxenburg, Kevin Bondar, Alina Syros, Neil Mohile, Danny Lee, Parham Rasoulinejad, Comron Saifi, and Chester Donnally.
    • Department of Orthopaedic Surgery and Department of Education, University of Miami, Miami, Florida, USA.
    • World Neurosurg. 2023 Feb 1; 170: 107113.e1107-113.e1.

    IntroductionMorbidly obese patients are at increased risk for intraoperative and postoperative complications following spinal fusion. Preoperative weight loss can improve clinical outcomes. The present systematic literature review is aimed to evaluate the hypothesis that bariatric surgery before spinal fusion surgery is associated with higher rates of complications and revisions.MethodsThree databases were queried for literature pertaining to bariatric surgery prior to spinal fusion. A 2-author screening process was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Methodologic index for non-randomized studies criteria was used to objectively assess the methodologic quality of the studies reviewed. Retrospective cohort studies in which the patients underwent bariatric surgery were included.ResultsFour retrospective cohort studies consisting of a total of 180,090 patients were included. Length of stay was significantly shorter for the bariatric surgery (BS) group patients than the control (C) groups patients (P = 0.009). There were no significant differences in 1-year mortality rate (P = 1.0), readmission rate (P = 0.86), overall postoperative complications (P = 0.83), and postoperative infections (P = 0.97) between the BS and C groups.ConclusionsThere were no consistent differences in rates of postoperative complications, infections, hospital readmission, and mortality between obese patients with bariatric surgery prior to spinal fusion and control group patients. The present study does not support the hypothesis that bariatric surgery before spinal fusion contributes to a higher rate of postoperative complications in patients undergoing spinal fusion.Copyright © 2022 Elsevier Inc. All rights reserved.

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