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Most obese or overweight people do not lose weight after successful lumbar decompression

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SAN FRANCISCO — Although many obese and overweight patients claim that they will lose weight after their pain due to lumbar stenosis is relieved, a study presented here indicates that most will not.

"Good-to-excellent outcomes following successful lumbar decompression for neurogenic claudication does not aid overweight or obese patients in losing weight," Ryan Garcia, MD, said. "Overweight or obese patients either gain or maintain their preoperative body weight at an average 30-month follow-up."

Garcia's comments came during the American Academy of Orthopaedic Surgeons 75th Annual Meeting, held here.

Overall, Garcia and colleagues studied 63 patients between the ages of 35 and 65 years. All patients had a body mass index (BMI) greater than 25 and underwent successful lumbar decompression surgery for neurogenic claudication secondary to spinal stenosis.

Surgery success was measured by a Zurich Claudication Questionnaire (ZCQ) between 2 years and 4.5 years after the procedure, and BMI and body weight was measured pre- and postoperatively.

Patients were included if they had chronic neurogenic symptoms for more than 6 months, had only a primary decompression and their ZCQ results were in the good to excellent range, Garcia said. Patients were excluded if they had any operative complications, any other spine procedure or an unsatisfactory outcome of the decompression.

The researchers noted that at follow-up both the overall mean body weight and BMI significantly increased by 2.48 kg and 0.83 kg/m².

"Patient's preoperative weight was highly associated with what their postoperative weight would be," Garcia said. "Six percent of patients in our study lost [greater than] 5% of their body weight, 35% gained [greater than] 5% of their preoperative body weight and 59% stayed within 5% of their preoperative weight."

He said that obesity is a complex and multifactorial disease which can lead to unrealistic expectations. "Patients should be encouraged preoperatively and postoperatively to lose weight and to participate in a weight-reduction program."

For more information:

• Garcia R, Messerschmitt P, Furey CG, et al. Does successful lumbar decompression aid weight loss in overweight and obese patients? Paper #529. Presented at the American Academy of Orthopaedic Surgeons 75th Annual Meeting. March 5-9, 2008. San Francisco.