Poster Presentation 50th International Society for the Study of the Lumbar Spine Annual Meeting 2024

Introduction: Amid the global obesity epidemic, its impact on spinal pathologies and surgeries has gained attention^1-3. While obesity is recognized as a risk factor for spinal issues, its specific influence on endoscopic spinal surgery outcomes remains understudied4. This study aimed to (1) assess the relationship between pre-operative BMI and post-operative outcomes in endoscopic spinal surgery, and (2) Equip clinicians with data to gauge the procedure's efficacy across different BMI classifications.

Methods: This retrospective analysis of 98 patients with spinal conditions who had undergone endoscopic surgery between August 2021 and January 2022 were included. Comprehensive patient data, including demographic information, preoperative clinical status, intraoperative details, clinical complications, and postoperative outcomes, were collected from electronic medical records. Surgical outcomes, include, Visual Analogue Scale (VAS) leg pain scores, VAS back pain scores, Oswestry Disability Index (ODI), Roland‐Morris Disability Questionnaire (RMDQ) scores, and the Quality-of-life EuroQol-5 Dimensions Questionnaire (EQ5D) scores, were assessed. Descriptive statistics, Estimation-Stats package, and Spearman’s rank correlations were used for statistical analysis, considering a P-value < 0.05 as statistically significant.

Results: The mean BMI of the patients was 29.72 ± 6.46, with 38.8% categorized as overweight. The analysis revealed significant negative correlations between BMI and both Delta-ODI (r=-.395, p=0.01) and Delta-RMDQ (r=-432, p =0.01). Furthermore, when assessed based on BMI categories, there was a significant negative correlation with BMI category and Delta-ODI (r=-.445, p=0.003) and Delta-RMDQ(r=-501, p=0.00). Higher BMI categories were significantly associated with less improvement in ODI-scores compared to a shared control. Improvement in ODI-scores was observed for all BMI categories postoperatively. No significant correlation between BMI and VAS back pain, VAS leg pain or quality of life were found

Conclusion: This study demonstrates that higher BMI is strongly negatively associated with postoperative improvement in disability for patients undergoing endoscopic surgical treatments. These findings emphasize the importance of addressing obesity as a modifiable risk factor to enhance patient outcomes after surgery. Surgeons should set realistic expectations for functional improvement when discussing endoscopic procedures with obese patients.