부산대학교 도서관

Background and purpose -- Obesity has been associated with inferior outcomes after laminectomy due to central lumbar spinal stenosis (CLSS); we evaluated whether this occurs in surgery on national bases. Patients and methods -- We retrieved pre- and 1-year postoperative data from the National Swedish Quality Registry for Spine Surgery regarding patients aged ≥ 50 with laminectomy due to CLSS in 2005--2018. 4,069 patients had normal weight, 7,044 were overweight, 3,377 had class I obesity, 577 class II obesity, and 94 class III obesity ("morbid obesity"). Patient-reported outcome included satisfaction after 1 year, leg pain (Numerical Rating Scale [NRS], rating 0--10), disability (Oswestry Disability Index [ODI], rating 0--100). Complications were also retrieved. Results -- 1-year postoperatively, 69% of patient of normal weight, 67% who were overweight, and 62% with obesity (classes I--III aggregated) were satisfied (p < 0.001) and 62%, 60%, and 57% in obese groups I--III, respectively (p = 0.7). NRS leg pain improved in normal-weight patients by 3.5 (95% CI 3.4--3.6), overweight by 3.2 (CI 3.1--3.2), and obese by 2.6 (CI 2.5--2.7), and 2.8 (CI 2.7--2.9), 2.5 (CI 2.2--2.7), and 2.6 (CI 2.0--3.2) in obese classes I--III, respectively. ODI improved in normal weight by 19 (CI 19--20), overweight by 17 (CI 17--18), and obese by 14 (CI 13--15), and 16 (CI 15--17), 14 (CI 13--16), 14 (CI 11--18) in obese classes I--III, respectively. 8.1% of normal weight, 7.0% of overweight, and 8.1% of obese patients suffered complications (p = 0.04) and 8.1%, 7.0%, and 17% among obese classes I--III, respectively (p < 0.01). Conclusion -- Most obese patients are satisfied after laminectomy due to CLSS, even if satisfaction rate is inferior compared with normal-weight patients. The morbidly obese have more complications than patients with lower BMI. [ABSTRACT FROM AUTHOR]