Morbid obesity ups complication rate in spinal fusion surgery

June 5, 2012
Morbid obesity ups complication rate in spinal fusion surgery
Morbid obesity increases the risk of multiple complications in spinal fusion surgery, particularly in patients undergoing anterior cervical or posterior lumbar procedures, according to research published in the May 15 issue of Spine.

(HealthDay) -- Morbid obesity increases the risk of multiple complications in spinal fusion surgery, particularly in patients undergoing anterior cervical or posterior lumbar procedures, according to research published in the May 15 issue of Spine.

To investigate whether impacts rates of complications and in patients undergoing spinal fusion, Paul A. Kalanithi, M.D., from Stanford University Hospitals and Clinics in California, and colleagues retrospectively analyzed all spinal fusions performed in California from 2003 to 2007. Data from the Healthcare Cost and Utilization Project's California State Inpatient Databases were used to identify normal-weight and patients admitted for four types of spinal fusion: anterior cervical, posterior cervical, anterior lumbar, and posterior lumbar.

The researchers found that, of the 84,607 admissions, 1,455 patients were morbidly obese. Morbid obesity correlated with higher in-hospital complication rates (13.6 versus 6.9 percent), which were seen across nearly all complication types, including cardiac, renal, pulmonary, and wound complications. Mortality was slightly, but significantly, higher among the morbidly obese (0.41 versus 0.13 percent; P < 0.01). Average hospital costs were significantly higher ($108,604 versus $84,861) and length of stay significantly longer (4.8 versus 3.5 days) for the morbidly obese. In posterior cervical fusions, all effects were less pronounced. In anterior cervical and posterior lumbar fusions, morbid obesity was the most significant predictor of complications.

"Morbid obesity seems to increase the risk of multiple complication types in , most particularly in anterior cervical and posterior lumbar approaches," the authors write.

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