PMID- 34050042
OWN - NLM
STAT- MEDLINE
DCOM- 20220329
LR  - 20230831
IS  - 2380-0194 (Electronic)
IS  - 2380-0186 (Linking)
VI  - 35
IP  - 1
DP  - 2022 Feb 1
TI  - Impact of Obesity Severity on Achieving a Minimum Clinically Important Difference 
      Following Minimally Invasive Transforaminal Lumbar Interbody Fusion.
PG  - E267-E273
LID - 10.1097/BSD.0000000000001205 [doi]
AB  - STUDY DESIGN: This was a retrospective cohort study. OBJECTIVE: The objective of 
      this study was to determine the impact of obesity on postoperative outcomes and 
      minimum clinically important difference (MCID) achievement following minimally 
      invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND 
      DATA: Obesity is a proven risk factor for poorer outcomes in MIS TLIF patients. 
      However, few studies have investigated the impact of body mass index (BMI) on 
      achievement of a MCID for Patient-Reported Outcome Measurement Information System 
      Physical Function (PROMIS PF). METHODS: A prospective surgical database was 
      retrospectively reviewed for primary, elective, single level MIS TLIF patients. 
      Patients were categorized into BMI groups: nonobese (<30 kg/m2); obese I (>/=30 and 
      <35 kg/m2); severe (>/=35 and <40 kg/m2); and morbid (>/=40 kg/m2). Demographic, 
      perioperative information, and complication rates were compared between groups. 
      Visual Analog Scale (VAS) back and leg, Oswestry Disability Index (ODI), 12-Item 
      Short Form-12 Physical Composite Score (SF-12 PCS), and PROMIS PF were collected 
      preoperatively and up to 2-year postoperatively. Impact of BMI on outcome 
      measures and MCID achievement at all timepoints was evaluated. RESULTS: A total 
      of 162 patients were included with 88 patients categorized as normal weight, 37 
      obese I, 25 severe, and 12 morbid. SF-12 PCS, and PROMIS PF significantly 
      differed by BMI at all timepoints, but only at 6- and 12-week for VAS back, 
      preoperatively and 12 weeks for VAS leg, and preoperatively to 1-year for ODI. 
      MCID achievement only differed for PROMIS PF and VAS back at 2 years, but did not 
      for overall MCID achievement. CONCLUSIONS: BMI is a significant predictor of ODI, 
      SF-12 PCS, and PROMIS PF preoperatively to 1-year postoperatively, but only 
      through 12-week for VAS scores. MCID achievement varied for PROMIS PF and VAS 
      back, suggesting that though BMI may affect postoperative outcome values, obesity 
      may impact a patient's perception of meaningful improvements in pain and physical 
      function.
CI  - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Cha, Elliot D K
AU  - Cha EDK
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Lynch, Conor P
AU  - Lynch CP
FAU - Mohan, Shruthi
AU  - Mohan S
FAU - Geoghegan, Cara E
AU  - Geoghegan CE
FAU - Jadczak, Caroline N
AU  - Jadczak CN
FAU - Singh, Kern
AU  - Singh K
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin Spine Surg
JT  - Clinical spine surgery
JID - 101675083
SB  - IM
MH  - Humans
MH  - *Lumbar Vertebrae/surgery
MH  - Minimally Invasive Surgical Procedures
MH  - Obesity/complications/surgery
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - *Spinal Fusion/adverse effects
MH  - Treatment Outcome
COIS- The authors declare no conflict of interest.
EDAT- 2021/05/30 06:00
MHDA- 2022/03/30 06:00
CRDT- 2021/05/29 05:42
PHST- 2020/10/14 00:00 [received]
PHST- 2021/04/14 00:00 [accepted]
PHST- 2021/05/30 06:00 [pubmed]
PHST- 2022/03/30 06:00 [medline]
PHST- 2021/05/29 05:42 [entrez]
AID - 01933606-202202000-00048 [pii]
AID - 10.1097/BSD.0000000000001205 [doi]
PST - ppublish
SO  - Clin Spine Surg. 2022 Feb 1;35(1):E267-E273. doi: 10.1097/BSD.0000000000001205.