Obesity has an impact on outcome in lumbar disc surgery

Voitto Järvimäki; Hannu Kautiainen; Maija Haanpää; Seppo Alahuhta; Merja Vakkala

doi:10.1016/j.sjpain.2015.10.003

Obesity has an impact on outcome in lumbar disc surgery

Scand J Pain. 2016 Jan:10:85-89. doi: 10.1016/j.sjpain.2015.10.003. Epub 2015 Nov 17.

Authors

Voitto Järvimäki¹, Hannu Kautiainen^{2

3

4}, Maija Haanpää^{5

6}, Seppo Alahuhta¹, Merja Vakkala¹

Affiliations

¹ Department of Anaesthesiology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
² Department of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland.
³ Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
⁴ Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.
⁵ Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland.
⁶ Mutual Insurance Company Etera, Helsinki, Finland.

PMID: 28361778
DOI: 10.1016/j.sjpain.2015.10.003

Abstract

Purpose: To investigate the effect of obesity on outcome in lumbar discectomy.

Methods: A cross-sectional postal survey; a self-made questionnaire, Beck depression inventory IA (BDI IA) and the Oswestry low back disability questionnaire (ODI) were sent to the patients, who had undergone lumbar disc surgery in the Oulu University Hospital between June 2005 and May 2008. Patients were divided into three groups according to BMI: normal, pre-obese and obese. The ODI was also examined in the framework of the international classification of functioning, disability and health (ICF) to investigate its ability to describe various dimensions of functioning (body structure and functions, activities and participation).

Results: The postal survey was sent to 642 patients, of whom 355 (55%) replied. Males dominated in the pre-obese (66%) and obese (62%) groups (p=0.01). Normal-weighted and pre-obese patients had lower BDI scores compared to obese patients (mean BDI: 8.0, 7.6, 11.2, respectively, p=0.035). Total ODI score was highest in the obese group compared to normal-weighted or pre-obese (20.3, 18.6, 26.4, respectively, p=0.011). When ODI was linked to the ICF there were significant differences in all activity domains (mobility, self-care and interpersonal interactions and relationships) and the mobility component of the participation domain between the weight groups.

Conclusions and implications: Obesity has an impact on outcome in lumbar discectomy. Obese patients had higher scores in BDI and ODI indicating mild mood disturbances and moderate functional disability. According to ICF, functional disability of obese patients was observed to some extent in all activity domains. Obese patients will be more frequently present for disc surgery and increased morbidity risk must be recognized. We need a strategy to rehabilitate and activate obese patients pre- and postoperatively.

Keywords: Beck depression inventory IA; Disability and health; International classification of functioning; Lumbar disc surgery; Oswestry disability index; Pain.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Disability Evaluation
Diskectomy*
Female
Humans
Lumbar Vertebrae / surgery
Male
Obesity / complications*
Pain Measurement
Treatment Outcome