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

January 10, 2013 in Surgery

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."

Journal reference: Journal of Bone and Joint Surgery search and more info website

Provided by American Academy of Orthopaedic Surgeons search and more info website

not rated yet  

Rank not rated yet
Relevant PhysicsForums posts

More news stories

More than one-third of Texas women still receive unnecessary breast biopsy surgery

Many women in Texas who are found to have an abnormality on routine mammogram or discover a lump in one of their breasts end up having an old-fashioned surgical biopsy to find out whether the breast abnormality is malignant. ...

Surgery created May 17, 2013 | popularity not rated yet | comments 0

Majority of surgical residents object to regulated hours

(HealthDay)—About 65 percent of surgical residents report that they disapprove of the 2011 Accreditation Council for Graduate Medical Education (ACGME) Common Program requirements, which place restrictions ...

Surgery created May 16, 2013 | popularity not rated yet | comments 0

Tissue damage from metal-on-metal hip implants appears before pain symptoms appear

Metal-on-metal hip implants can cause inflammation of the joint lining (synovitis) long before symptoms appear, and magnetic resonance imaging (MRI) can be used to identify this inflammation, according to ...

Surgery created May 15, 2013 | popularity not rated yet | comments 0

Robotic transplant an option for obese kidney patients

Obese patients who received robotic kidney transplants had fewer wound complications than patients who received traditional "open" transplant surgery, according to surgeons at the University of Illinois Hospital ...

Surgery created May 15, 2013 | popularity not rated yet | comments 0

Indian medics conduct 'perfect' op on baby's swollen head (Update)

Doctors carried out life-saving surgery Wednesday on an Indian baby suffering from a rare disorder that caused her head to swell to nearly double its size, in a case that aroused sympathy worldwide.

Surgery created May 15, 2013 | popularity not rated yet | comments 0


Lymphatic fluid takes detour

When tumours metastasise, they can block lymphatic vessels, as researchers from ETH Zurich have discovered using a new method. The lymphatic fluid subsequently has to find a new path through the tissue. Such ...

Research uncovers a potential role of two proteins in diabetes

(Medical Xpress)—Flinders University researchers are breaking new ground in a decade-long journey to pinpoint the function of two closely related proteins.

Vitamin D could provide new and effective treatments for asthma

(Medical Xpress)—Scientists at King's College London have discovered that Vitamin D has the potential to significantly reduce the symptoms of asthma. The study, led by Professor Catherine Hawrylowicz from ...

Rethinking treatment goals improves results for 'untreatable' anorexics

(Medical Xpress)—Patients with the most severe and dangerous form of chronic anorexia are more likely to make a significant improvement towards recovery and stay in therapy if traditional psychological treatments are re-focused ...

Discovery of novel medicine for treatment of chronic wounds

Every 20 seconds, a limb is lost as a consequence of diabetic foot ulcer that does not heal. To date, medical solutions that can change this situation are very limited. In his doctoral thesis Yue Shen from the Industrial ...

Novel mechanism allows Legionella to hide in body

(Medical Xpress)—The feared Legionella pneumophila is responsible for legionellosis, an infectious disease that can lead to pneumonia. To infect humans, this pathogen has developed a complex method that allows it to camouflage ...