Abstract
BackgroundIn this study we intended to prove that being overweight has an unfavorable impact on the surgical treatment outcome of adult idiopathic scoliosis (AdIS).MethodsThis is a retrospective study on the surgical treatment of seventy-one more than 30 years old (58 females and 13 males; mean age 42.9±12.2) idiopathic scoliotic patients with a minimum follow up of at least 2 years. The patients were divided into an overweight group (BMI≥23) and a non-overweight group (BMI<23). Preoperative, postoperative first erect and final follow-up radiographic measures, perioperative data, the Oswestry disability index (ODI), and the visual analog scale (VAS) were reviewed and compared.FindingsIn the overweight group, no significant differences in radiographic measures, perioperative data, preoperative comorbidities, or postoperative complications, except for the more frequent concomitance of preoperative thoracic kyphosis 37.9±7.7 vs. 26.5±11.8 (P = 0.000) and thoracolumbar kyphosis 14.9±10.1 overweighted group vs. 6.5±9.9 non-overweighted group respectively (P = 0.002) were found. A higher morbidity of hypertension 36.8% vs. 9.6% (P = 0.004) was also observed in the overweight group. Postoperative ODI and VAS improved significantly in both groups compared to pre-operative values. The postoperative ODI of the overweight group (19.6±12.4) was significantly higher than that of the non-overweight group (12.4±7.9) (P = 0.022).ConclusionsOverweight adult idiopathic scoliotic patients had more frequent concomitance of preoperative thoracic kyphosis and thoracolumbar kyphosis and more serious postoperative pain. However, BMI did not affect the outcomes of surgical correction for coronal and sagittal scoliotic deformity and their postoperative complication rates were not significantly affected.
Highlights
According to statistics from the World Health Organization (WHO), obesity has reached epidemic proportions; more than one billion adults are classified as being overweighted, and at least 300 million of these adults are classified as clinically obese
Body mass index (BMI) did not affect the outcomes of surgical correction for coronal and sagittal scoliotic deformity and their postoperative complication rates were not significantly affected
Overweight patients were more likely to have pre-existing hypertension, their postoperative complication rates were not significantly affected. In this retrospective analysis we investigated the effect of obesity on outcomes of surgical scoliosis treatments, because overweight is a general stress factor for joints and is leading to accelerated spinal degeneration with age
Summary
According to statistics from the World Health Organization (WHO), obesity has reached epidemic proportions; more than one billion adults are classified as being overweighted, and at least 300 million of these adults are classified as clinically obese. Obesity contributes to numerous non-communicable chronic diseases and leads to more healthcare expenditures than any other medical condition. Body mass index (BMI), an index calculated using one’s weight and height, is a reliable indicator of body fatness for most people, and it has been used to screen weight categories that may lead to health problems. It has been used by the National Institutes of Health to categorize patients based on their health risks [2]. In this study we intended to prove that being overweight has an unfavorable impact on the surgical treatment outcome of adult idiopathic scoliosis (AdIS)
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