Effect of Obesity on Radiographic Alignment and Short-Term Complications After Surgical Treatment of Adult Cervical Deformity

International Spine Study Group

Research output: Contribution to journalArticle

Abstract

Objective: We investigated the 30-day complication incidence and 1-year radiographic correction in obese patients undergoing surgical treatment of cervical deformity. Methods: The patients were stratified according to World Health Organization's definition for obesity: obese, patients with a body mass index of ≥30 kg/m 2 ; and nonobese, patients with a body mass index of <30 kg/m 2 . The patients had undergone surgery for the treatment of cervical deformity. The patient baseline demographic, comorbidity, and radiographic data were compared between the 2 groups at baseline and 1 year postoperatively. The 30-day complication incidence was stratified according to complication severity (any, major, or minor), and type (cardiopulmonary, dysphagia, infection, neurological, and operative). Binary logistic regression models were used to assess the effect of obesity on developing those complications, with adjustment for patient age and levels fused. Results: A total of 124 patients were included, 53 obese and 71 nonobese patients. The 2 groups had a similar T1 slope minus cervical lordosis (obese, 37.2° vs. nonobese, 36.9°; P = 0.932) and a similar C2–C7 (−5.9° vs. −7.3°; P = 0.718) and C2–C7 (50.1 mm vs. 44.1 mm; P = 0.184) sagittal vertical axis. At the 1-year follow-up examination, the T1 pelvic angle (1.0° vs. −3.1°; P = 0.021) and C2–S1 sagittal vertical axis (−5.9 mm vs. −35.0 mm; P = 0.036) were different, and the T1 spinopelvic inclination (−1.0° vs. −2.9°; P = 0.123) was similar. The obese patients had a greater risk of overall short-term complications (odds ratio, 2.5; 95% confidence interval, 1.1–6.1) and infectious complications (odds ratio, 5.0; 95% confidence interval, 1.0–25.6). Conclusions: Obese patients had a 5 times greater odds of developing infections after surgery for adult cervical deformity. Obese patients also showed significantly greater pelvic anteversion after cervical correction.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StatePublished - Jan 1 2019

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Obesity
Therapeutics
Body Mass Index
Logistic Models
Odds Ratio
Confidence Intervals
Lordosis
Incidence
Deglutition Disorders
Infection
Comorbidity
Demography

Keywords

  • Alignment
  • Cervical deformity
  • Complications
  • Obese
  • Obesity
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Effect of Obesity on Radiographic Alignment and Short-Term Complications After Surgical Treatment of Adult Cervical Deformity. / International Spine Study Group.

In: World Neurosurgery, 01.01.2019.

Research output: Contribution to journalArticle

@article{6344d1a002fc4d108432d1b7a01e879b,
title = "Effect of Obesity on Radiographic Alignment and Short-Term Complications After Surgical Treatment of Adult Cervical Deformity",
abstract = "Objective: We investigated the 30-day complication incidence and 1-year radiographic correction in obese patients undergoing surgical treatment of cervical deformity. Methods: The patients were stratified according to World Health Organization's definition for obesity: obese, patients with a body mass index of ≥30 kg/m 2 ; and nonobese, patients with a body mass index of <30 kg/m 2 . The patients had undergone surgery for the treatment of cervical deformity. The patient baseline demographic, comorbidity, and radiographic data were compared between the 2 groups at baseline and 1 year postoperatively. The 30-day complication incidence was stratified according to complication severity (any, major, or minor), and type (cardiopulmonary, dysphagia, infection, neurological, and operative). Binary logistic regression models were used to assess the effect of obesity on developing those complications, with adjustment for patient age and levels fused. Results: A total of 124 patients were included, 53 obese and 71 nonobese patients. The 2 groups had a similar T1 slope minus cervical lordosis (obese, 37.2° vs. nonobese, 36.9°; P = 0.932) and a similar C2–C7 (−5.9° vs. −7.3°; P = 0.718) and C2–C7 (50.1 mm vs. 44.1 mm; P = 0.184) sagittal vertical axis. At the 1-year follow-up examination, the T1 pelvic angle (1.0° vs. −3.1°; P = 0.021) and C2–S1 sagittal vertical axis (−5.9 mm vs. −35.0 mm; P = 0.036) were different, and the T1 spinopelvic inclination (−1.0° vs. −2.9°; P = 0.123) was similar. The obese patients had a greater risk of overall short-term complications (odds ratio, 2.5; 95{\%} confidence interval, 1.1–6.1) and infectious complications (odds ratio, 5.0; 95{\%} confidence interval, 1.0–25.6). Conclusions: Obese patients had a 5 times greater odds of developing infections after surgery for adult cervical deformity. Obese patients also showed significantly greater pelvic anteversion after cervical correction.",
keywords = "Alignment, Cervical deformity, Complications, Obese, Obesity, Surgery",
author = "{International Spine Study Group} and Passias, {Peter G.} and Poorman, {Gregory W.} and Horn, {Samantha R.} and Jalai, {Cyrus M.} and Cole Bortz and Frank Segreto and Diebo, {Bassel M.} and Alan Daniels and Hamilton, {D. Kojo} and Daniel Sciubba and Justin Smith and Brian Neuman and Shaffrey, {Christopher I.} and Virginie LaFage and Renaud LaFage and Frank Schwab and Shay Bess and Christopher Ames and Robert Hart and Alexandra Soroceanu and Gregory Mundis and Robert Eastlack",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.wneu.2019.01.248",
language = "English (US)",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

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TY - JOUR

T1 - Effect of Obesity on Radiographic Alignment and Short-Term Complications After Surgical Treatment of Adult Cervical Deformity

AU - International Spine Study Group

AU - Passias, Peter G.

AU - Poorman, Gregory W.

AU - Horn, Samantha R.

AU - Jalai, Cyrus M.

AU - Bortz, Cole

AU - Segreto, Frank

AU - Diebo, Bassel M.

AU - Daniels, Alan

AU - Hamilton, D. Kojo

AU - Sciubba, Daniel

AU - Smith, Justin

AU - Neuman, Brian

AU - Shaffrey, Christopher I.

AU - LaFage, Virginie

AU - LaFage, Renaud

AU - Schwab, Frank

AU - Bess, Shay

AU - Ames, Christopher

AU - Hart, Robert

AU - Soroceanu, Alexandra

AU - Mundis, Gregory

AU - Eastlack, Robert

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: We investigated the 30-day complication incidence and 1-year radiographic correction in obese patients undergoing surgical treatment of cervical deformity. Methods: The patients were stratified according to World Health Organization's definition for obesity: obese, patients with a body mass index of ≥30 kg/m 2 ; and nonobese, patients with a body mass index of <30 kg/m 2 . The patients had undergone surgery for the treatment of cervical deformity. The patient baseline demographic, comorbidity, and radiographic data were compared between the 2 groups at baseline and 1 year postoperatively. The 30-day complication incidence was stratified according to complication severity (any, major, or minor), and type (cardiopulmonary, dysphagia, infection, neurological, and operative). Binary logistic regression models were used to assess the effect of obesity on developing those complications, with adjustment for patient age and levels fused. Results: A total of 124 patients were included, 53 obese and 71 nonobese patients. The 2 groups had a similar T1 slope minus cervical lordosis (obese, 37.2° vs. nonobese, 36.9°; P = 0.932) and a similar C2–C7 (−5.9° vs. −7.3°; P = 0.718) and C2–C7 (50.1 mm vs. 44.1 mm; P = 0.184) sagittal vertical axis. At the 1-year follow-up examination, the T1 pelvic angle (1.0° vs. −3.1°; P = 0.021) and C2–S1 sagittal vertical axis (−5.9 mm vs. −35.0 mm; P = 0.036) were different, and the T1 spinopelvic inclination (−1.0° vs. −2.9°; P = 0.123) was similar. The obese patients had a greater risk of overall short-term complications (odds ratio, 2.5; 95% confidence interval, 1.1–6.1) and infectious complications (odds ratio, 5.0; 95% confidence interval, 1.0–25.6). Conclusions: Obese patients had a 5 times greater odds of developing infections after surgery for adult cervical deformity. Obese patients also showed significantly greater pelvic anteversion after cervical correction.

AB - Objective: We investigated the 30-day complication incidence and 1-year radiographic correction in obese patients undergoing surgical treatment of cervical deformity. Methods: The patients were stratified according to World Health Organization's definition for obesity: obese, patients with a body mass index of ≥30 kg/m 2 ; and nonobese, patients with a body mass index of <30 kg/m 2 . The patients had undergone surgery for the treatment of cervical deformity. The patient baseline demographic, comorbidity, and radiographic data were compared between the 2 groups at baseline and 1 year postoperatively. The 30-day complication incidence was stratified according to complication severity (any, major, or minor), and type (cardiopulmonary, dysphagia, infection, neurological, and operative). Binary logistic regression models were used to assess the effect of obesity on developing those complications, with adjustment for patient age and levels fused. Results: A total of 124 patients were included, 53 obese and 71 nonobese patients. The 2 groups had a similar T1 slope minus cervical lordosis (obese, 37.2° vs. nonobese, 36.9°; P = 0.932) and a similar C2–C7 (−5.9° vs. −7.3°; P = 0.718) and C2–C7 (50.1 mm vs. 44.1 mm; P = 0.184) sagittal vertical axis. At the 1-year follow-up examination, the T1 pelvic angle (1.0° vs. −3.1°; P = 0.021) and C2–S1 sagittal vertical axis (−5.9 mm vs. −35.0 mm; P = 0.036) were different, and the T1 spinopelvic inclination (−1.0° vs. −2.9°; P = 0.123) was similar. The obese patients had a greater risk of overall short-term complications (odds ratio, 2.5; 95% confidence interval, 1.1–6.1) and infectious complications (odds ratio, 5.0; 95% confidence interval, 1.0–25.6). Conclusions: Obese patients had a 5 times greater odds of developing infections after surgery for adult cervical deformity. Obese patients also showed significantly greater pelvic anteversion after cervical correction.

KW - Alignment

KW - Cervical deformity

KW - Complications

KW - Obese

KW - Obesity

KW - Surgery

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U2 - 10.1016/j.wneu.2019.01.248

DO - 10.1016/j.wneu.2019.01.248

M3 - Article

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -