Obesity Means more Spine Surgery Complications

Obesity Means more Spine Surgery Complications

Obesity Means more Spine Surgery Complications

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Obesity means more Spine Surgery Complications.  Surgeons cannot be politically correct about  Obesity.  The truth is Obesity makes surgery more difficult,  and less successful.

In the April 1, 2015 Edition of Spine,  Dr. Burks,  from the University of Virginia reviewed the data on Obesity and the associated rates of Incidental Durotomy during Lumbar Surgery.    It is well know that obesity has been associated with increased rates of complications such as wound infection,  blood loss,  and even mortality.  Likewise,  Obesity is associated with longer surgery times,  higher costs,  and greater risk of developing medical events such as heart attack,  breathing issues,  and blood clots.   To complete the analysis,  it means worse outcomes.

Dr. Burks and colleagues looked a the data regarding lumbar spine surgery,  and compared the obese  ( body mass index greater than 30),  the morbidly obese (BMI greater than 40),  and normal body weight patients.

The data analysis shows  non obese patients to have a significantly less rate of  these incidental durotomies.

As a spine surgeon,  I found this data interesting,  as previously,  it was thought these dural  openings are most associated with more complicated,  or revision type surgeries.  But this paper shows that even within groups of patients with revision,  or more complicated surgeries,  there is still a higher rate of dural openings when stratified by non-obese vs obese.

As a Spine Surgeon,  I know that obesity is definitely a factor in terms of planning the surgery,  counseling the patient,  and predicting an outcome.  As I have been in practice for more than 20 years,  I usually counsel obese patients to try to lose weight before any elective surgery.   In a fair number of instances,  the weight loss itself took care of the problem and surgery was cancelled.  To me,  sometimes,  the obesity,  and the associated medical conditions such as heart disease,  diabetes,  and diffuse arthritis makes the risk of surgery not worth any anticipated improvements.  In that situation,  I would advise against surgery.

While I cannot counsel obese patients on HOW to lose the weight,  I certainly can counsel obese patients when the risks overshadow the chances of a successful surgery.  It makes for a difficult conversation.  Unfortunately,  not everyone will accept my recommendations against surgery.  At the same time,  I am sure Obese patients can find Surgeons willing to take on the greater risks.  Just understand,  another Surgeon will not take away the risks associated with your obesity,  or your medical conditions.    In life or death matters,  the risk should be accepted.  In elective surgery,  the risk should be discussed, and quantified.      

Citations

  • Burks CA, Werner BC, Yang S, Shimer AL. Obesity is associated with an increased rate of incidental durotomy in lumbar spine surgery. Spine (Phila Pa 1976). 2015 Apr 1;40(7):500-4. PubMed PMID: 25599288

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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