Similar improvement seen in obese patients after open, MIS deformity surgery

NEW ORLEANS — Obese adults who undergo open or minimally invasive deformity surgery will likely experience similar postoperative improvement in Oswestry Disability Index and VAS scores, based on a retrospective analysis of patients in two databases.

According to data presented by Paul Park, MD, at the Congress of Neurological Surgeons Annual Meeting, estimated blood loss (EBL) was significantly less in patients who had minimally invasive surgery (MIS). The EBL was 600.8 mL and 1386.8 mL in the MIS and open groups, respectively (P = .001), according to results presented here.

“In terms of clinical outcomes…within each group, MIS and open, patients were statistically better after surgery, and that is for [Oswestry Disability Index] ODI, VAS and leg pain,” Park said. “Between the groups there was no difference in outcomes statistically, so they pretty much had equivalent outcomes.”

Park and colleagues studied the two techniques for spine deformity procedures performed in 38 obese patients, two groups of 19 patients each, to verify the benefits of MIS and if the reported technical difficulties were valid. One database they queried included open surgeries and the other database included MIS cases.

To be included in the study, patients needed to be diagnosed with adult spinal deformity, have a BMI greater than or equal to 30, and have either a coronal Cobb angle of 20°, sagittal vertical axis greater than 5 cm, pelvic tilt greater than 25° or thoracic kyphosis greater than 60°. Patients needed at least a 2-year follow-up and were propensity matched according to fusion levels.

Other findings showed the radiographic outcomes, reoperation rates and complications, which were mostly infection-related, were not statistically different in the groups.

The data collection process and the sample size of 19 patients per group were among the study’s limitations, Park said.

“This may have not been powered adequately to effectively detect a difference,” he said. – by Susan M. Rapp

Reference:

Park P, et al. Paper #167. Presented at: Congress of Neurological Surgeons Annual Meeting; Sept. 26-30, 2015; New Orleans.

Disclosure: Park reports he is a consultant to Biomet, Globus and Medtronic and he receives royalties from Globus.