Study finds poorer outcomes for obese patients treated for lumbar disc herniation

While obese patients are more likely to have surgical treatment for lumbar disc herniation – a slipped or ruptured disc – than nonobese patients, obesity increases operative time, blood loss and length of hospital stay, according to new research published in the January 2013 Journal of Bone and Joint Surgery (JBJS). Overall, obese patients had poorer outcomes with surgical and nonsurgical treatments for lumbar disc herniation than nonobese patients.

The study included 854 nonobese patients with a (BMI) of less than 30 kg/m², and 336 with a BMI greater than 30 kg/m², enrolled in the Spine Patient Outcomes Research Trial (SPORT) for the treatment of lumbar disc herniation. Researchers compiled patient demographic and clinical characteristics at baseline, and then compared that information with data compiled during regular follow-up visits for four years.

At four years, improvements in function were less for obese patients – in both the surgical and nonsurgical groups – as measured by the . Reported pain (using the Short Form-36 scale) was statistically similar for obese and non-obese patients.

"The findings suggest that obese patients with symptomatic lumbar disc herniation do not do as well as nonobese patients with nonsurgical or surgical treatment," said Jeffrey Rihn, MD, associate professor at Thomas Jefferson University Hospital and The Rothman Institute.

Other Key Findings:

  • Obese patients did not have an increased rate of infection, intraoperative complications, recurrent disc herniation or reoperation.
  • Obese patients had significantly less improvement in the Sciatica Bothersomeness Index and Bothersomeness Index, but reported no significant difference in self-rated overall improvement/satisfaction.
  • The benefit of surgery over nonoperative treatment was not affected by body mass index.
  • Recurrence of disc herniation and need for additional surgical procedures did not differ significantly between obese and nonobese patients. This finding contradicts previous studies on this topic.
"The results of this study may be helpful in educating patients about their treatment options and expected outcomes," said Dr. Rihn. "These findings may suggest that weight loss should be encouraged in patients with this condition. However, this study does not specifically address whether weight loss in obese patients would affect their clinical outcome with nonsurgical or surgical treatment."

add to favorites email to friend print save as pdf

Related Stories

Surgical treatment within six months of lumbar disc herniation

Oct 25, 2011

A new study in the Journal of Bone and Joint Surgery (JBJS) found that patients with herniated lumbar disc symptoms were significantly worse if the patients had symptoms for more than six months prior to treatment, compared to t ...

Oxiplex improves outcomes after lumbar discectomy

Apr 24, 2012

(HealthDay) -- The use of Oxiplex gel (containing carboxymethylcellulose, polyethylene oxide, and calcium) to coat the surgical site during discectomy procedures for the treatment of lumbar disc herniation ...

Knee replacement not an 'easy solution' for obese patients

Oct 24, 2012

Obese patients have a greater risk of complications following total knee replacement surgery, including post-surgical infections, according to a new literature review recently published in the Journal of Bone and Joint Su ...

Recommended for you

Surgery for spinal metastasis up from 2000 to 2009 in US

23 hours ago

(HealthDay)—From 2000 to 2009 there was an increase in surgical treatment for spinal metastasis in the United States, which was accompanied by increased complication rates and costs, according to a study ...

User comments