• Wolfgang Senker, Christian Meznik, Alexander Avian, and Andrea Berghold.
• Department of Orthopedic Surgery, General Hospital Amstetten, Krankenhausstrasse 21, 3300 Amstetten, Austria. wolfgang.senker@aon.at
• Eur Spine J. 2011 Jul 1; 20 (7): 1182-7.

AbstractThe medical profession is increasingly confronted with the epidemic phenomenon of obesity. Its impact on spine surgery is not quite clear. Published data concerning the use of minimally invasive surgery (MIS) in the spine among obese patients is scarce. The purpose of the present retrospective study was to evaluate perioperative as well as postoperative complication rates in MIS fusion of the lumbar spine in obese, overweight and normal patients classified according to their body mass index. Lumbar MIS fusion was performed by means of TLIF procedures and/or posterolateral fusion alone. A laminotomy was performed in patients with spinal stenosis. Of 72 patients, 39 underwent additional laminotomy for spinal stenosis. No differences were registered in respect of the numbers of fused segments or cages. Any harmful event occurring peri- or postoperatively was noted and included in the statistical analysis. No infection at the site of surgery or severe wound healing disorder was encountered. We registered no difference in blood loss, drainage, or the length of the hospital stay between the three BMI groups. We also observed no difference in complication rates between the three groups. This study confirms the low soft tissue damage of minimal access surgery techniques, which is an important type of surgery in obese patients. The smaller approach helps to minimize infections and wound healing disorders. Moreover, deeper regions of wounds are clearly visualized with the aid of tubular retractors.

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