276 - Does Greater Body Mass Index Increase the Risk for Revision Procedures...

General Session: MIS-4

Presented by: B. Mayo - View Audio/Video Presentation (Members Only)

Author(s):

D. Bohl(1), J. Ahn(1), B. Mayo(1), D. Massel(1), W. Long(1), K. Modi(1), B. Basques(1), K. Singh(1)

(1) Rush University Medical Center, Orthopaedic Surgery, Chicago, IL, United States

Abstract

Background information: Studies conflict as to whether greater BMI contributes to recurrent herniation and the need for revision procedures following LD. Patients and surgeons would benefit from knowing whether greater BMI is a risk factor in order to guide the decision whether to pursue an operative versus non-operative treatment.

Objective: To examine the association between body mass index (BMI) and the risk for undergoing a revision procedure following a single-level minimally invasive (MIS) lumbar discectomy (LD).

Methods: Patients undergoing a single-level MIS LD were retrospectively identified in our institution's prospectively maintained surgical registry. BMI was categorized as normal weight (< 25kg/m2), overweight (25-30kg/m2), obese (30-40kg/m2), or morbidly obese (≥40kg/m2). Multivariate analysis was used to test for association with requiring a revision procedure during the first two postoperative years. The model was demographics, comorbidities, and operative level.

Results: A total of 226 patients were identified. Of these, 56 (24.8%) were normal weight, 80 (35.4%) were overweight, 66 (29.2%) were obese, and 24 (10.6%) were morbidly obese. A total of 23 patients (10.2%) underwent a revision procedure in the first two postoperative years. The two-year risk for revision procedure was 1.8% for normal weight patients, 12.5% for overweight patients, 9.1% for obese patients, and 25.0% for morbidly obese patients. In the multivariate-adjusted analysis model, BMI category was independently associated with undergoing a revision procedure (p=0.038).

Conclusions: These findings indicate that greater BMI is an independent risk factor for undergoing a revision procedure following a LD. These findings conflict with recent studies that have found no difference between obese and non-obese patients in regards to risk for recurrent herniation and/or revision procedures. Patients with greater body mass index undergoing LD should be informed they could have an elevated risk for revision procedures.