@article{161ebfd7d4f446c89d4d992b25816af4,
title = "Prior bariatric surgery lowers complication rates following spine surgery in obese patients",
abstract = "Background: Bariatric surgery (BS) is an increasingly common treatment for morbid obesity that has the potential to effect bone and mineral metabolism. The effect of prior BS on spine surgery outcomes has not been well established. The aim of this study was to assess differences in complication rates following spinal surgery for patients with and without a history of BS. Methods: Retrospective analysis of the prospectively collected New York State Inpatient Database (NYSID) years 2004–2013. BS patients and morbidly obese patients (non-BS) were divided into cervical and thoracolumbar surgical groups and propensity score matched for age, gender, and invasiveness and complications compared. Results: One thousand nine hundred thirty-nine spine surgery patients with a history of BS were compared to 1625 non-BS spine surgery patients. The average time from bariatric surgery to spine surgery is 2.95 years. After propensity score matching, 740 BS patients were compared to 740 non-BS patients undergoing thoracolumbar surgery, with similar comorbidity rates. The overall complication rate for BS thoracolumbar patients was lower than non-BS (45.8% vs 58.1%, P < 0.001), with lower rates of device-related (6.1% vs 23.2%, P < 0.001), DVT (1.2% vs 2.7%, P = 0.039), and hematomas (1.5% vs 4.5%, P < 0.001). Neurologic complications were similar between BS patients and non-BS patients (2.3% vs 2.7%, P = 0.62). For patients undergoing cervical spine surgery, BS patients experienced lower rates of bowel issues, device-related, and overall complication than non-BS patients (P < 0.05). Conclusions: Bariatric surgery patients undergoing spine surgery experience lower overall complication rates than morbidly obese patients. This study warrants further investigation into these populations to mitigate risks associated with spine surgery for bariatric patients.",
keywords = "Bariatric surgery, Complications, Morbid obesity, Spine surgery",
author = "Passias, {Peter G.} and Horn, {Samantha R.} and Dennis Vasquez-Montes and Nicholas Shepard and Segreto, {Frank A.} and Bortz, {Cole A.} and Poorman, {Gregory W.} and Jalai, {Cyrus M.} and Charles Wang and Nicholas Stekas and Frangella, {Nicholas J.} and Chloe Deflorimonte and Diebo, {Bassel G.} and Micheal Raad and Shaleen Vira and Horowitz, {Jason A.} and Sciubba, {Daniel M.} and Hamid Hassanzadeh and Renaud Lafage and John Afthinos and Virginie Lafage",
note = "Funding Information: Conflict of interest Dr. Passias reports personal fees from Medicrea, personal fees from SpineWave, non-financial support from Allosource, personal fees from Zimmer Biomet, personal fees from Globus, grants from CSRS, and personal fees from Aesculap, outside the submitted work. Dr. Sciubba reports consulting for Medtronic, DePuy Synthes, Stryker, NuVasive, and K2M, outside the submitted work. Dr. Hassanzadeh reports consulting for NuVasive, research support from Pfizer, and grant from Orthofix, outside the submitted work. Dr. Lafage reports stock ownership of Nemaris INC, speaking and/or teaching arrangements from NuVasive, DePuy Spine, Nemaris INC, Medicrea, and board of directors for Nemaris INC, and grants from SRS, NIH, and DePuy Spine, outside the submitted work. All other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers{\textquoteright} bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript. Funding Information: The NYSID was developed by the Healthcare Cost and Utilization Project with support from the Agency for Healthcare Research and Quality. NYSID contains patient information from billing codes and captures patients who are covered under Medicare, Medicaid, or private insurance. It includes over 100 clinical and nonclinical variables that are derived from a hospital discharge abstract, including primary and secondary diagnoses and procedures, admission and discharge status, and demographics including age, sex, race, payment source, charges, and hospital length of stay. The database utilizes International Classification of Diseases Ninth Revision Clinical Modification codes (ICD-9-CM) to identify diagnoses and procedures. Unique patient linkage codes allow identification of multiple and return inpatient stays over time. Funding Information: This article is part of the Topical Collection on Spine – Other Dr. Passias reports personal fees from Medicrea, personal fees from SpineWave, non-financial support from Allosource, personal fees from Zimmer Biomet, personal fees from Globus, grants from CSRS, and personal fees from Aesculap, outside the submitted work. Dr. Sciubba reports consulting for Medtronic, DePuy Synthes, Stryker, NuVasive, and K2M, outside the submitted work. Dr. Hassanzadeh reports consulting for NuVasive, research support from Pfizer, and grant from Orthofix, outside the submitted work. Dr. Lafage reports stock ownership of Nemaris INC, speaking and/or teaching arrangements from NuVasive, DePuy Spine, Nemaris INC, Medicrea, and board of directors for Nemaris INC, and grants from SRS, NIH, and DePuy Spine, outside the submitted work. All other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers{\textquoteright} bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript. This shows a good paper touching a growing problem in western world societies such as morbid obesity and its implications where undergoing spinal surgery. Jesus Lafuente Barcelona, Spain Publisher Copyright: {\textcopyright} 2018, Springer-Verlag GmbH Austria, part of Springer Nature.",
year = "2018",
month = dec,
day = "1",
doi = "10.1007/s00701-018-3722-6",
language = "English (US)",
volume = "160",
pages = "2459--2465",
journal = "Acta Neurochirurgica",
issn = "0001-6268",
publisher = "Springer Wien",
number = "12",
}