A study recently published in Spine examined whether obesity is associated with reduced disc height in the lumbar spine.
The researchers examined 72 patients from a community-based study of musculoskeletal health and they found:
1. Obese individuals had a reduced average and total disc height when compared with nonobese patients. The average height in obese patients was 1.04 cm, compared with 1.14 cm. The total disc height in obese patients was 4.16 cm, compared with 4.57 cm. The researchers controlled for age, sex and height.
Among obese patients who do undergo surgery — specifically transforaminal lumbar interbody fusion — there are fewer complications if the patients undergo minimally invasive procedures, according to a study published in the Journal of Spinal Disorders & Techniques. Radiographic evidence showed satisfactory bony union at the fixed level in both the minimally invasive and open groups.
2. There was no significant relationship between reduced disc heights and obesity at the lumbosacral junction, despite the differences identified at L1-L2 and L3-L4. "Obesity was associated with reduced disc height in the lumbar spine, but not at the lumbosacral junction, suggesting these joints may have different risk factors," concluded the study authors.
3. The average and total lumbar disc heights were negatively associated with recent pain after the researchers adjusted for sex, age and height. But the relationships became insignificant when also adjusting for weight. Among obese patients who undergo TLIF, patients report less pain after undergoing minimally invasive procedures than open procedures. However, the two groups had nearly identical Oswestry Disability Index scores.
4. There was no significant relationship between disc height and recent pain at the lumbosacral junction. "There was also evidence for an inter-relationship between obesity, lumbar disc height and recent pain, suggesting that structural changes have a role in back pain and may in part explain the association between obesity and back pain," the study authors concluded.
5. A 2012 study published in Spine and highlighted in HealthDay found morbidly obese patients had a complication rate of nearly 14 percent, compared with 7 percent for other patients, meaning morbid obesity increased complication risk by 97 percent.
The study also found morbidly obese patients who underwent spinal fusion had higher hospital costs — $109,000 compared with $85,000 for non-morbidly obese patients — and stayed in the hospital 1.3 days longer.
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