P117. An evaluation of preoperative patient weight and body mass index during single-position minimally invasive spine surgery

Abstract

<h3>BACKGROUND CONTEXT</h3> The single position minimally invasive (MIS) approach allows access to the anterior and posterior columns with the ability to mitigate complications associated with open procedures while achieving circumferential fusion. The purpose of this study was to identify if patient weight or body mass index (BMI) leads to differences in intraoperative event rates. <h3>PURPOSE</h3> To determine if patient weight and BMI will correlate with the occurrence of intraoperative events during MIS spine surgery. <h3>STUDY DESIGN/SETTING</h3> Retrospective cohort. <h3>PATIENT SAMPLE</h3> A total of 524 MIS patients. <h3>OUTCOME MEASURES</h3> Weight (kg), BMI (kg/m2), Aborted procedures, estimated blood loss (EBL), operative time (OpTime). <h3>METHODS</h3> Of 524 patients eligible, 226 (43.1%) had available data. Of these, 88 met inclusion criteria (52 Lat and 36 PL). The majority were male (49, 55.7%), mean age of 49.2 yrs and 2.0 levels fused and 18 (20.5%) undergoing an osteotomy. Lat patients with a weight > 130 kg had significantly longer OpTime (p=0.003) and more EBL (p=0.019). There was a significant difference in mean weight for lat patients with (121.8 kg) and without (97.7 kg) an aborted procedure, p=0.021. There was also a significant difference in mean BMI for lat patients with (35.3 kg/m2) and without (29.6 kg/m2) an aborted procedure, p=0.015. Multivariable analysis showed that weight (OR 1.03 [CI 1.01-1.06], p=.020) and BMI (OR 1.15 [CI 1.02-1.30], p=.026) were independent predictors for aborted procedures in lat patients. In an analysis of PL patients, there was one aborted case (weight > 120 kg), but no significant findings for EBL or OpTime. <h3>RESULTS</h3> Of 524 patients eligible, 226 (43.1%) had available data. Of these, 88 met inclusion criteria (52 Lat and 36 PL). The majority were male (49, 55.7%), mean age of 49.2 yrs and 2.0 levels fused and 18 (20.5%) undergoing an osteotomy. Lat patients with a weight > 130 kg had significantly longer OpTime (p=0.003) and more EBL (p=0.019). There was a significant difference in mean weight for lat patients with (121.8 kg) and without (97.7 kg) an aborted procedure, p=0.021. There was also a significant difference in mean BMI for lat patients with (35.3 kg/m2) and without (29.6 kg/m2) an aborted procedure, p=0.015. Multivariable analysis showed that weight (OR 1.03 [CI 1.01-1.06], p=.020) and BMI (OR 1.15 [CI 1.02-1.30], p=.026) were independent predictors for aborted procedures in lat patients. In an analysis of PL patients, there was one aborted case (weight > 120 kg), but no significant findings for EBL or OpTime. <h3>CONCLUSIONS</h3> Weight and BMI appear to be independently associated with aborted procedures for patients in the lateral decubitus position during minimally invasive spine surgery. Patients in the lateral decubitus position who weighed 130 kg or more had on average longer operative times and more estimated blood lost. This study has the potential to help with risk stratification in the future when determining patients undergoing a single position procedure. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.