Impact of Obesity on Outcomes in Adults Undergoing Elective Posterior Cervical Fusion

• Published in: Spine (Philadelphia, Pa. 1976)
• Main Authors: Phan, Kevin, Kothari, Parth, Lee, Nathan J, Virk, Sohaib, Kim, Jun S, Cho, Samuel K
• Format: Journal Article
• Language: English
• Published: United States 15.02.2017
• ISSN: 1528-1159
• DOI: 10.1097/BRS.0000000000001711

Retrospective study of prospectively collected data OBJECTIVE.: To determine the impact of obesity (BMI > 30) on postoperative morbidity & mortality following elective posterior cervical fusion in adults. In those with spine disease, obesity has been shown to portend poorer general and disease-specific functional health status. However, the impact of obesity on outcomes following spine surgery, especially posterior cervical fusion, remains unclear. Previous studies have been contradictory to one another and largely limited by small sample sizes. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) is a large multicenter clinical registry that prospectively collects preoperative risk factors, intraoperative variables, and 30-day postoperative morbidity and mortality outcomes from about 400 hospitals nationwide. Current Procedural Terminology (CPT) codes were used to query the database for adults who underwent posterior cervical fusion between 2005-2012. Patients were separated into cohorts based on obese status. Univariate analysis and multivariate logistic regression were used to analyze the impact of obesity on postoperative morbidity and mortality. There was a significantly higher rate of only venous thromboembolism (VTE) in the obese group compared to non-obese cohort (3.5% vs 0.6%, P = 0.015). On multivariate analysis, obesity was found to be an independent predictor (odds ratio [OR] 6.15; 95% CI, 1.26-30.20; P = 0.02) for VTE. The present study demonstrated obese patients can safely undergo posterior cervical fusion surgery. Although obesity predisposed to an elevated risk of VTE, post-operative mortality and morbidity were otherwise not significantly increased in this population. 3.