• World Neurosurg · Jul 2023

    Review Meta Analysis

    Do Obese Patients Lose Weight After Lumbar Spine Surgery: A Systematic Review and Meta-Analysis.

    • Phillip Vorster, Abhijith V Matur, Paolo Palmisciano, Fatu S Conteh, Louisa Onyewadume, Henry O Duah, Geet G Shukla, Sai S Chilakapati, Xu Tao, Sahil Gupta, Sanjit Shah, Benjamin Motley, Joseph Cheng, Justin Virojanapa, and Owoicho Adogwa.
    • Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
    • World Neurosurg. 2023 Jul 1; 175: 122129.e1122-129.e1.

    ObjectiveObesity is a major health care concern in the United States and is associated with high rates of postoperative complications after spine surgery. Obese patients assert that weight reduction is not possible unless spine surgery first relieves their pain and concomitant immobility. We describe the post-spine surgery effects on patient weight, with an emphasis on obesity.MethodsPubMed, EMBASE, Scopus, Web of Science, and Cochrane databases were systematically searched according to the PRISMA guidelines. The search included indexed terms and text words from database inception to the date of the search (15 April 2022). Studies chosen for inclusion had to have data reporting on pre- and postoperative patient weight after spine surgery. Data and estimates were pooled using the Mantel-Haenszel method for random-effects meta-analysis.ResultsEight articles encompassing 7 retrospective and 1 prospective cohort were identified. A random effects model analysis demonstrated that overweight and obese patients (body mass index [BMI], >25 kg/m2) had increased odds of clinically significant weight loss after lumbar spine surgery compared with non-obese patients (odds ratio, 1.63; 95% confidence interval, 1.43-1.86, P < 0.0001). There was no significant difference in the raw weight change between BMI categories (mean difference, -0.67 kg, 95% confidence interval, -4.71 to 3.37 kg, P = 0.7463).ConclusionsCompared with non-obese patients (BMI, <25 kg/m2), overweight and obese patients have higher odds of clinically significant weight loss after lumbar spine surgery. No difference in pre-operative and post-operative weight was found, although statistical power was lacking in this analysis. Randomized controlled trials and additional prospective cohorts are needed to further validate these findings.Copyright © 2023 Elsevier Inc. All rights reserved.

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