Suess Olaf, Kombos Theodoros, Bode Frank
Zentrum fuer Wirbelsaeulenchirurgie und Neurotraumatologie, DRK Kliniken Berlin Westend, Spandauer Damm 130, 14050 Berlin, Germany.
Neurochirurgische Klinik, Schlosspark Klinik, Heubnerweg 2, 14059 Berlin, Germany.
Int J Chronic Dis. 2016;2016:2964625. doi: 10.1155/2016/2964625. Epub 2016 Jul 10.
Background. Posterior lumbar interbody fusion (PLIF) is a common surgical treatment for degenerative spinal instability, but many surgeons consider obesity a contraindication for elective spinal fusion. The aim of this study was to analyze whether obesity has any influence on hospitalization parameters, change in clinical status, or complications. Methods. In this prospective study, regression analysis was used to analyze the influence of the body mass index (BMI) on operating time, postoperative care, hospitalization time, type of postdischarge care, change in paresis or sensory deficits, pain level, wound complications, cerebrospinal fluid leakage, and implant complications. Results. Operating time increased only 2.5 minutes for each increase of BMI by 1. The probability of having a wound complication increased statistically with rising BMI. Nonetheless, BMI accounted for very little of the variation in the data, meaning that other factors or random chances play a much larger role. Conclusions. Obesity has to be considered a risk factor for wound complications in patients undergoing elective PLIF for degenerative instability. However, BMI showed no significant influence on other kinds of peri- or postoperative complications, nor clinical outcomes. So obesity cannot be considered a contraindication for elective PLIF.
背景。腰椎后路椎间融合术(PLIF)是治疗退行性脊柱不稳的一种常见手术方法,但许多外科医生认为肥胖是选择性脊柱融合术的禁忌证。本研究的目的是分析肥胖是否对住院参数、临床状态变化或并发症有任何影响。方法。在这项前瞻性研究中,采用回归分析来分析体重指数(BMI)对手术时间、术后护理、住院时间、出院后护理类型、轻瘫或感觉障碍变化、疼痛程度、伤口并发症、脑脊液漏和植入物并发症的影响。结果。BMI每增加1,手术时间仅增加2.5分钟。随着BMI的升高,发生伤口并发症的概率在统计学上增加。尽管如此,BMI在数据变异中所占比例很小,这意味着其他因素或随机因素起的作用要大得多。结论。对于因退行性不稳而接受选择性PLIF手术的患者,肥胖必须被视为伤口并发症的一个危险因素。然而,BMI对其他类型的围手术期或术后并发症以及临床结果没有显著影响。因此,肥胖不能被视为选择性PLIF的禁忌证。