Prior bariatric surgery lowers complication rates following spine surgery in obese patients

Peter G. Passias, Samantha R. Horn, Dennis Vasquez-Montes, Nicholas Shepard, Frank A. Segreto, Cole A. Bortz, Gregory W. Poorman, Cyrus M. Jalai, Charles Wang, Nicholas Stekas, Nicholas J. Frangella, Chloe Deflorimonte, Bassel G. Diebo, Micheal Raad, Shaleen Vira, Jason A. Horowitz, Daniel M. Sciubba, Hamid Hassanzadeh, Renaud Lafage, John AfthinosVirginie Lafage

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
Pages (from-to)2459-2465
Number of pages7
JournalActa Neurochirurgica
Volume160
Issue number12
DOIs
StatePublished - Dec 1 2018
Externally publishedYes

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Bariatric Surgery
Spine
Propensity Score
Equipment and Supplies
Morbid Obesity
Hematoma

Keywords

  • Bariatric surgery
  • Complications
  • Morbid obesity
  • Spine surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Passias, P. G., Horn, S. R., Vasquez-Montes, D., Shepard, N., Segreto, F. A., Bortz, C. A., ... Lafage, V. (2018). Prior bariatric surgery lowers complication rates following spine surgery in obese patients. Acta Neurochirurgica, 160(12), 2459-2465. https://doi.org/10.1007/s00701-018-3722-6

Prior bariatric surgery lowers complication rates following spine surgery in obese patients. / Passias, Peter G.; Horn, Samantha R.; Vasquez-Montes, Dennis; Shepard, Nicholas; Segreto, Frank A.; Bortz, Cole A.; Poorman, Gregory W.; Jalai, Cyrus M.; Wang, Charles; Stekas, Nicholas; Frangella, Nicholas J.; Deflorimonte, Chloe; Diebo, Bassel G.; Raad, Micheal; Vira, Shaleen; Horowitz, Jason A.; Sciubba, Daniel M.; Hassanzadeh, Hamid; Lafage, Renaud; Afthinos, John; Lafage, Virginie.

In: Acta Neurochirurgica, Vol. 160, No. 12, 01.12.2018, p. 2459-2465.

Research output: Contribution to journalArticle

Passias, PG, Horn, SR, Vasquez-Montes, D, Shepard, N, Segreto, FA, Bortz, CA, Poorman, GW, Jalai, CM, Wang, C, Stekas, N, Frangella, NJ, Deflorimonte, C, Diebo, BG, Raad, M, Vira, S, Horowitz, JA, Sciubba, DM, Hassanzadeh, H, Lafage, R, Afthinos, J & Lafage, V 2018, 'Prior bariatric surgery lowers complication rates following spine surgery in obese patients', Acta Neurochirurgica, vol. 160, no. 12, pp. 2459-2465. https://doi.org/10.1007/s00701-018-3722-6
Passias PG, Horn SR, Vasquez-Montes D, Shepard N, Segreto FA, Bortz CA et al. Prior bariatric surgery lowers complication rates following spine surgery in obese patients. Acta Neurochirurgica. 2018 Dec 1;160(12):2459-2465. https://doi.org/10.1007/s00701-018-3722-6
Passias, Peter G. ; Horn, Samantha R. ; Vasquez-Montes, Dennis ; Shepard, Nicholas ; Segreto, Frank A. ; Bortz, Cole A. ; Poorman, Gregory W. ; Jalai, Cyrus M. ; Wang, Charles ; Stekas, Nicholas ; Frangella, Nicholas J. ; Deflorimonte, Chloe ; Diebo, Bassel G. ; Raad, Micheal ; Vira, Shaleen ; Horowitz, Jason A. ; Sciubba, Daniel M. ; Hassanzadeh, Hamid ; Lafage, Renaud ; Afthinos, John ; Lafage, Virginie. / Prior bariatric surgery lowers complication rates following spine surgery in obese patients. In: Acta Neurochirurgica. 2018 ; Vol. 160, No. 12. pp. 2459-2465.
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T1 - Prior bariatric surgery lowers complication rates following spine surgery in obese patients

AU - Passias, Peter G.

AU - Horn, Samantha R.

AU - Vasquez-Montes, Dennis

AU - Shepard, Nicholas

AU - Segreto, Frank A.

AU - Bortz, Cole A.

AU - Poorman, Gregory W.

AU - Jalai, Cyrus M.

AU - Wang, Charles

AU - Stekas, Nicholas

AU - Frangella, Nicholas J.

AU - Deflorimonte, Chloe

AU - Diebo, Bassel G.

AU - Raad, Micheal

AU - Vira, Shaleen

AU - Horowitz, Jason A.

AU - Sciubba, Daniel M.

AU - Hassanzadeh, Hamid

AU - Lafage, Renaud

AU - Afthinos, John

AU - Lafage, Virginie

PY - 2018/12/1

Y1 - 2018/12/1

N2 - 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.

AB - 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.

KW - Bariatric surgery

KW - Complications

KW - Morbid obesity

KW - Spine surgery

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