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Bone Joint J. 2015 Oct;97-B(10):1395-404. doi: 10.1302/0301-620X.97B10.35724.

Outcome of lumbar spinal fusion surgery in obese patients: a systematic review and meta-analysis.

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University Hospital Of North Tees and Hartlepool, Stockton on Tees TS19 8PE, UK.
Teesside University, Middlesbrough TS1 3BA, UK.
Wansbeck General Hospital, Ashington, NE63 9JJ, UK.


The aim of this study was to determine whether obesity affects pain, surgical and functional outcomes following lumbar spinal fusion for low back pain (LBP). A systematic literature review and meta-analysis was made of those studies that compared the outcome of lumbar spinal fusion for LBP in obese and non-obese patients. A total of 17 studies were included in the meta-analysis. There was no difference in the pain and functional outcomes. Lumbar spinal fusion in the obese patient resulted in a statistically significantly greater intra-operative blood loss (weighted mean difference: 54.04 ml; 95% confidence interval (CI) 15.08 to 93.00; n = 112; p = 0.007) more complications (odds ratio: 1.91; 95% CI 1.68 to 2.18; n = 43858; p < 0.001) and longer duration of surgery (25.75 mins; 95% CI 15.61 to 35.90; n = 258; p < 0.001). Obese patients have greater intra-operative blood loss, more complications and longer duration of surgery but pain and functional outcome are similar to non-obese patients. Based on these results, obesity is not a contraindication to lumbar spinal fusion.


low back pain; lumbar spinal fusion; meta-analysis.; obesity; systematic review

[Indexed for MEDLINE]

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