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/m2; and nonobese, patients with a body mass index of <30 kg/m2. 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 language | English (US) |
|---|---|
| Pages (from-to) | e1082-e1088 |
| Journal | World Neurosurgery |
| Volume | 125 |
| DOIs | |
| State | Published - May 2019 |
Keywords
- Alignment
- Cervical deformity
- Complications
- Obese
- Obesity
- Surgery
ASJC Scopus subject areas
- Surgery
- Clinical Neurology
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Effect of Obesity on Radiographic Alignment and Short-Term Complications After Surgical Treatment of Adult Cervical Deformity. / International Spine Study Group.
In: World Neurosurgery, Vol. 125, 05.2019, p. e1082-e1088.Research output: Contribution to journal › Article › peer-review
}
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
N1 - Funding Information: Conflict of interest statement: The International Spine Study Group is funded through research grants from DePuy Synthes and individual donations. Dr. Passias reports a consultancy with Medicrea and Spinewave, speaking or teaching arrangements with Zimmer Biomet, a grant from CSRS, and scientific advisory board membership at Allosource. Dr. Daniels reports a consultancy with Stryker, DePuy Synthes, Globus, and Stryker and research/fellowship support from Orthofix. Dr. Sciubba reports consultancy with DePuy Synthes, Medtronic, Stryker, NuVasive, and K2M. Dr. Smith reports grants from DePuy Synthes, consultancy with Zimmer-Biomet, NuVasive, and Cerapedics, royalties from Zimmer-Biomet, speaking or teaching arrangements from Zimmer-Biomet and Nuvasive. Dr. Shaffrey reports grants from DePuy Synthes, National Institutes of Health, Department of Defense, and AOSpine; a consultancy with Medtronic, Nuvasive, Zimmer Biomet, K2M, Stryker, and In Vivo; royalties/patents from Medtronic, Nuvasive, and Zimmer Biomet; and stockholder earnings from Nuvasive. Dr. Lafage reports grants from SRS, DePuy, K2M, Stryker, and NuVasive; speaking or teaching arrangements from DePuy, MSD, and AOSpine; consultancy from NuVasive; and shareholder/board of directors for Nemaris Inc. Dr. Schwab reports royalties from Zimmer Biomet, MSD, and K2M; stock ownership in Nemaris Inc.; consulting for NuVasive, Zimmer Biomet, and Medtronic; speaking and teaching for MSD, NuVasive, and Zimmer Biomet; membership on the board of directors for Nemaris Inc.; and grants from DePuy Spine, NuVasive, Stryker, and K2M. Dr. Bess reports consultancy for K2M and Allosource and support of non–study-related clinical or research efforts from DePuy Synthes, Medtronic, NuVasive, K2M, and Orthofix. Dr. Ames reports grants from DePuy; consultancy from DePuy, Medtronic, Stryker; and royalties from Stryker and Zimmer Biomet. Dr. Hart reports grant from Medtronic; speaking fees from Globus, Seaspine, and DePuy; and other disclosures from CSRS, ISSG, and ISSLS. Dr. Mundis reports a consultancy from K2M and DePuy Synthes; royalties from K2M; and nonfinancial support from Nuvasive. Funding Information: Conflict of interest statement: The International Spine Study Group is funded through research grants from DePuy Synthes and individual donations. Dr. Passias reports a consultancy with Medicrea and Spinewave, speaking or teaching arrangements with Zimmer Biomet, a grant from CSRS , and scientific advisory board membership at Allosource. Dr. Daniels reports a consultancy with Stryker, DePuy Synthes, Globus, and Stryker and research/fellowship support from Orthofix . Dr. Sciubba reports consultancy with DePuy Synthes , Medtronic, Stryker, NuVasive, and K2M. Dr. Smith reports grants from DePuy Synthes , consultancy with Zimmer-Biomet, NuVasive, and Cerapedics, royalties from Zimmer-Biomet, speaking or teaching arrangements from Zimmer-Biomet and Nuvasive. Dr. Shaffrey reports grants from DePuy Synthes , National Institutes of Health, Department of Defense, and AOSpine; a consultancy with Medtronic, Nuvasive, Zimmer Biomet, K2M, Stryker, and In Vivo; royalties/patents from Medtronic, Nuvasive, and Zimmer Biomet; and stockholder earnings from Nuvasive. Dr. Lafage reports grants from SRS , DePuy , K2M , Stryker , and NuVasive ; speaking or teaching arrangements from DePuy, MSD, and AOSpine; consultancy from NuVasive; and shareholder/board of directors for Nemaris Inc. Dr. Schwab reports royalties from Zimmer Biomet, MSD, and K2M; stock ownership in Nemaris Inc.; consulting for NuVasive, Zimmer Biomet, and Medtronic; speaking and teaching for MSD, NuVasive, and Zimmer Biomet; membership on the board of directors for Nemaris Inc.; and grants from DePuy Spine , NuVasive , Stryker , and K2M . Dr. Bess reports consultancy for K2M and Allosource and support of non–study-related clinical or research efforts from DePuy Synthes , Medtronic , NuVasive , K2M , and Orthofix . Dr. Ames reports grants from DePuy ; consultancy from DePuy, Medtronic, Stryker; and royalties from Stryker and Zimmer Biomet. Dr. Hart reports grant from Medtronic ; speaking fees from Globus, Seaspine, and DePuy; and other disclosures from CSRS, ISSG, and ISSLS. Dr. Mundis reports a consultancy from K2M and DePuy Synthes; royalties from K2M; and nonfinancial support from Nuvasive . Funding Information: Conflict of interest statement: The International Spine Study Group is funded through research grants from DePuy Synthes and individual donations. Dr. Passias reports a consultancy with Medicrea and Spinewave, speaking or teaching arrangements with Zimmer Biomet, a grant from CSRS, and scientific advisory board membership at Allosource. Dr. Daniels reports a consultancy with Stryker, DePuy Synthes, Globus, and Stryker and research/fellowship support from Orthofix. Dr. Sciubba reports consultancy with DePuy Synthes, Medtronic, Stryker, NuVasive, and K2M. Dr. Smith reports grants from DePuy Synthes, consultancy with Zimmer-Biomet, NuVasive, and Cerapedics, royalties from Zimmer-Biomet, speaking or teaching arrangements from Zimmer-Biomet and Nuvasive. Dr. Shaffrey reports grants from DePuy Synthes, National Institutes of Health, Department of Defense, and AOSpine; a consultancy with Medtronic, Nuvasive, Zimmer Biomet, K2M, Stryker, and In Vivo; royalties/patents from Medtronic, Nuvasive, and Zimmer Biomet; and stockholder earnings from Nuvasive. Dr. Lafage reports grants from SRS, DePuy, K2M, Stryker, and NuVasive; speaking or teaching arrangements from DePuy, MSD, and AOSpine; consultancy from NuVasive; and shareholder/board of directors for Nemaris Inc. Dr. Schwab reports royalties from Zimmer Biomet, MSD, and K2M; stock ownership in Nemaris Inc.; consulting for NuVasive, Zimmer Biomet, and Medtronic; speaking and teaching for MSD, NuVasive, and Zimmer Biomet; membership on the board of directors for Nemaris Inc.; and grants from DePuy Spine, NuVasive, Stryker, and K2M. Dr. Bess reports consultancy for K2M and Allosource and support of non?study-related clinical or research efforts from DePuy Synthes, Medtronic, NuVasive, K2M, and Orthofix. Dr. Ames reports grants from DePuy; consultancy from DePuy, Medtronic, Stryker; and royalties from Stryker and Zimmer Biomet. Dr. Hart reports grant from Medtronic; speaking fees from Globus, Seaspine, and DePuy; and other disclosures from CSRS, ISSG, and ISSLS. Dr. Mundis reports a consultancy from K2M and DePuy Synthes; royalties from K2M; and nonfinancial support from Nuvasive. Conflict of interest statement: The International Spine Study Group is funded through research grants from DePuy Synthes and individual donations. Dr. Passias reports a consultancy with Medicrea and Spinewave, speaking or teaching arrangements with Zimmer Biomet, a grant from CSRS, and scientific advisory board membership at Allosource. Dr. Daniels reports a consultancy with Stryker, DePuy Synthes, Globus, and Stryker and research/fellowship support from Orthofix. Dr. Sciubba reports consultancy with DePuy Synthes, Medtronic, Stryker, NuVasive, and K2M. Dr. Smith reports grants from DePuy Synthes, consultancy with Zimmer-Biomet, NuVasive, and Cerapedics, royalties from Zimmer-Biomet, speaking or teaching arrangements from Zimmer-Biomet and Nuvasive. Dr. Shaffrey reports grants from DePuy Synthes, National Institutes of Health, Department of Defense, and AOSpine; a consultancy with Medtronic, Nuvasive, Zimmer Biomet, K2M, Stryker, and In Vivo; royalties/patents from Medtronic, Nuvasive, and Zimmer Biomet; and stockholder earnings from Nuvasive. Dr. Lafage reports grants from SRS, DePuy, K2M, Stryker, and NuVasive; speaking or teaching arrangements from DePuy, MSD, and AOSpine; consultancy from NuVasive; and shareholder/board of directors for Nemaris Inc. Dr. Schwab reports royalties from Zimmer Biomet, MSD, and K2M; stock ownership in Nemaris Inc.; consulting for NuVasive, Zimmer Biomet, and Medtronic; speaking and teaching for MSD, NuVasive, and Zimmer Biomet; membership on the board of directors for Nemaris Inc.; and grants from DePuy Spine, NuVasive, Stryker, and K2M. Dr. Bess reports consultancy for K2M and Allosource and support of non?study-related clinical or research efforts from DePuy Synthes, Medtronic, NuVasive, K2M, and Orthofix. Dr. Ames reports grants from DePuy; consultancy from DePuy, Medtronic, Stryker; and royalties from Stryker and Zimmer Biomet. Dr. Hart reports grant from Medtronic; speaking fees from Globus, Seaspine, and DePuy; and other disclosures from CSRS, ISSG, and ISSLS. Dr. Mundis reports a consultancy from K2M and DePuy Synthes; royalties from K2M; and nonfinancial support from Nuvasive. Publisher Copyright: © 2019 Elsevier Inc.
PY - 2019/5
Y1 - 2019/5
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/m2; and nonobese, patients with a body mass index of <30 kg/m2. 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/m2; and nonobese, patients with a body mass index of <30 kg/m2. 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
UR - http://www.scopus.com/inward/record.url?scp=85063049465&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063049465&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2019.01.248
DO - 10.1016/j.wneu.2019.01.248
M3 - Article
C2 - 30790725
AN - SCOPUS:85063049465
VL - 125
SP - e1082-e1088
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
ER -