Lumbar fusion surgery in obese patients: radiological outcomes and complications

Background Global health care is steadily dealing with the increasing impacts of the rising Obesity epidemic which is steadily impacting the delivery of health care. This is bringing with it an increased complexity in the delivery and management of many diseases. One such common condition is degenerative spinal disease which has an increasing prevalence over a lifetime. We conducted a single centre retrospective analysis which focused on Lumbar spinal fusion for degenerative spinal disease in Obese adult patients, specifically looking at the intra-operative and post-operative complications in the surgical management of these patients and radiological outcomes. Results At total of 28 patients over 5 years were included in the analysis with an average BMI of 35.5. Of the total subjects there was a spread of different surgical approaches with the largest being that of a Posterior Lumbar Interbody Fusion which was 50%. 28% of the study subjects had a diagnosis of diabetes and 57% had Hypertension. From the study population there was a 17.9% of return to theatre in the same admission, 12% infection rate and a fusion rate of 71% at 12 months, this was seen most commonly in the Posterior Lumbar Interbody Fusion. Conclusion This study demonstrates the intraoperative and post operative challenges of managing lumbar canal stenosis in obese adults with higher rates of return to theatre, infection and lower fusion rates. This is important area of further research given the increasing rates of obesity and an aging population.