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Prior bariatric surgery lowers complication rates following spine surgery in obese patients.

A new interesting article has been published in Acta Neurochir (Wien). 2018 Dec;160(12):2459-2465. doi: 10.1007/s00701-018-3722-6. Epub 2018 Nov 8. and titled:

Prior bariatric surgery lowers complication rates following spine surgery in obese patients.

Authors of this article are:

Passias PG, Horn SR, Vasquez-Montes D, Shepard N, Segreto FA, Bortz CA, Poorman GW, Jalai CM, Wang C, Stekas N, Frangella NJ, Deflorimonte C, Diebo BG, Raad M, Vira S, Horowitz JA, Sciubba DM, Hassanzadeh H, Lafage R, Afthinos J, Lafage V.

A summary of the article is shown below:

BACKGROUND: Bariatric surgery (BS) is an increasingly common treatment for morbid obesity that has the potential to effect bone and mineral metabolism. The effect of prior BS on spine surgery outcomes has not been well established. The aim of this study was to assess differences in complication rates following spinal surgery for patients with and without a history of BS.METHODS: Retrospective analysis of the prospectively collected New York State Inpatient Database (NYSID) years 2004-2013. BS patients and morbidly obese patients (non-BS) were divided into cervical and thoracolumbar surgical groups and propensity score matched for age, gender, and invasiveness and complications compared.RESULTS: One thousand nine hundred thirty-nine spine surgery patients with a history of BS were compared to 1625 non-BS spine surgery patients. The average time from bariatric surgery to spine surgery is 2.95 years. After propensity score matching, 740 BS patients were compared to 740 non-BS patients undergoing thoracolumbar surgery, with similar comorbidity rates. The overall complication rate for BS thoracolumbar patients was lower than non-BS (45.8% vs 58.1%, P < 0.001), with lower rates of device-related (6.1% vs 23.2%, P < 0.001), DVT (1.2% vs 2.7%, P = 0.039), and hematomas (1.5% vs 4.5%, P < 0.001). Neurologic complications were similar between BS patients and non-BS patients (2.3% vs 2.7%, P = 0.62). For patients undergoing cervical spine surgery, BS patients experienced lower rates of bowel issues, device-related, and overall complication than non-BS patients (P < 0.05).CONCLUSIONS: Bariatric surgery patients undergoing spine surgery experience lower overall complication rates than morbidly obese patients. This study warrants further investigation into these populations to mitigate risks associated with spine surgery for bariatric patients.
Check out the article’s website on Pubmed for more information:

This article is a good source of information and a good way to become familiar with topics such as:

Bariatric surgery;Complications;Morbid obesity;Spine surgery


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