PMID- 36892729
OWN - NLM
STAT- MEDLINE
DCOM- 20230531
LR  - 20230607
IS  - 0942-0940 (Electronic)
IS  - 0001-6268 (Linking)
VI  - 165
IP  - 6
DP  - 2023 Jun
TI  - Impact of body mass index on PROMIS outcomes following lumbar decompression.
PG  - 1427-1434
LID - 10.1007/s00701-023-05534-5 [doi]
AB  - BACKGROUND: No studies have examined the impact of body mass index (BMI) on newer 
      Patient-Reported Outcomes Measurement Information System (PROMIS) outcomes in 
      patients undergoing lumbar decompression (LD). METHODS: Patients undergoing LD 
      with preoperative PROMIS measures were stratified into four cohorts: normal 
      (18.5 </= BMI < 25 kg/m(2)), overweight (25 </= BMI < 30 kg/m(2)), obese I 
      (30 </= BMI < 35 kg/m(2)), and obese II-III (BMI >/= 35 kg/m(2)). Demographics, 
      perioperative characteristics, and patient-reported outcomes (PROs) were 
      obtained. PROs of PROMIS Physical Function (PROMIS-PF), PROMIS Anxiety 
      (PROMIS-A), PROMIS Pain Interference (PROMIS-PI), PROMIS Sleep Disturbance 
      (PROMIS-SD), Patient Health Questionnaire-9 (PHQ-9), Visual Analog Scale (VAS) 
      Back Pain (VAS-BP), VAS Leg Pain (VAS-LP), and Oswestry Disability Index (ODI) 
      were collected at preoperative and up to 2-year postoperative time points. 
      Minimum clinically important difference (MCID) achievement was determined through 
      comparison of previously established values. Comparison between cohorts were 
      determined through inferential statistics. RESULTS: A total of 473 patients were 
      identified, with stratification of 125 patients in the normal cohort, 161 in the 
      overweight cohort, 101 in the obese I cohort, and 87 in the obese II-III cohort. 
      Mean postoperative follow-up time was 13.51 +/- 8.72 months. Higher BMI patients 
      had higher operative times, longer postoperative length of stay, and greater 
      narcotic consumption (p </= 0.001, all). Patients with higher BMI (obese I, obese 
      II-III) reported inferior preoperative PROMIS-PF, VAS-BP, and ODI scores 
      (p </= 0.003, all). Postoperatively, obese I-III cohorts demonstrated inferior 
      PROMIS-PF, PHQ-9, VAS-BP, and ODI scores at final follow-up (p </= 0.016, all). 
      However, patients demonstrated similar postoperative changes and MCID achievement 
      regardless of preoperative BMI. CONCLUSION: Patients undergoing lumbar 
      decompression demonstrated similar postoperative improvement in physical 
      function, anxiety, pain interference, sleep disturbance, mental health, pain, and 
      disability outcomes independent of preoperative BMI. However, obese patients 
      reported worse physical function, mental health, back pain, and disability 
      outcomes at final postoperative follow-up. Patients with greater BMI undergoing 
      lumbar decompression demonstrate inferior postoperative clinical outcomes.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, 
      part of Springer Nature.
FAU - Nie, James W
AU  - Nie JW
AUID- ORCID: 0000-0002-6680-009X
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St., Suite #300, IL, 60612, Chicago, USA.
FAU - Hartman, Timothy J
AU  - Hartman TJ
AUID- ORCID: 0000-0003-3937-3480
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St., Suite #300, IL, 60612, Chicago, USA.
FAU - Zheng, Eileen
AU  - Zheng E
AUID- ORCID: 0000-0002-2444-6790
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St., Suite #300, IL, 60612, Chicago, USA.
FAU - Oyetayo, Omolabake O
AU  - Oyetayo OO
AUID- ORCID: 0000-0002-6098-7121
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St., Suite #300, IL, 60612, Chicago, USA.
FAU - MacGregor, Keith R
AU  - MacGregor KR
AUID- ORCID: 0000-0003-4557-828X
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St., Suite #300, IL, 60612, Chicago, USA.
FAU - Federico, Vincent P
AU  - Federico VP
AUID- ORCID: 0000-0003-3749-9282
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St., Suite #300, IL, 60612, Chicago, USA.
FAU - Massel, Dustin H
AU  - Massel DH
AUID- ORCID: 0000-0002-8147-5555
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St., Suite #300, IL, 60612, Chicago, USA.
FAU - Sayari, Arash J
AU  - Sayari AJ
AUID- ORCID: 0000-0001-6450-2438
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St., Suite #300, IL, 60612, Chicago, USA.
FAU - Singh, Kern
AU  - Singh K
AUID- ORCID: 0000-0002-6118-7273
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St., Suite #300, IL, 60612, Chicago, USA. kern.singh@rushortho.com.
LA  - eng
PT  - Journal Article
DEP - 20230309
PL  - Austria
TA  - Acta Neurochir (Wien)
JT  - Acta neurochirurgica
JID - 0151000
SB  - IM
MH  - Humans
MH  - Body Mass Index
MH  - *Overweight/etiology
MH  - Back Pain
MH  - Obesity/complications/surgery
MH  - Decompression
MH  - Lumbar Vertebrae/surgery
MH  - Treatment Outcome
MH  - *Spinal Fusion/adverse effects
MH  - Patient Reported Outcome Measures
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Body mass index
OT  - Lumbar decompression
OT  - Patient-Reported Outcomes Measurement Information System
OT  - Patient-reported outcomes
EDAT- 2023/03/10 06:00
MHDA- 2023/05/31 06:42
CRDT- 2023/03/09 11:18
PHST- 2023/01/25 00:00 [received]
PHST- 2023/02/11 00:00 [accepted]
PHST- 2023/05/31 06:42 [medline]
PHST- 2023/03/10 06:00 [pubmed]
PHST- 2023/03/09 11:18 [entrez]
AID - 10.1007/s00701-023-05534-5 [pii]
AID - 10.1007/s00701-023-05534-5 [doi]
PST - ppublish
SO  - Acta Neurochir (Wien). 2023 Jun;165(6):1427-1434. doi: 
      10.1007/s00701-023-05534-5. Epub 2023 Mar 9.