The Effect of High Obesity on Outcomes of Treatment for Lumbar Spinal Conditions

Subgroup Analysis of the Spine Patient Outcomes Research Trial

Kevin J. McGuire, MD, MS; Mohammed A. Khaleel, MD, MS; Jeffrey A. Rihn, MD; Jon D. Lurie, MD, MS; Wenyan Zhao, PhD; James N. Weinstein, DO, MS


Spine. 2014;39(23):1975-1980. 

In This Article


Extremely obese patients had greatest rates of comorbidity and the lowest SF-36 physical function scores in each arm of the study. No significant differences in surgical treatment effect or operative events were found among nonobese patients, obese patients, and extremely obese patients treated for lumbar SpS. Increased operative times and infection rates were seen by the extremely obese patients who underwent surgery for spondylolisthesis; however, the majority of surgery for spondylolisthesis involved instrumentation and longer operative times. Surgical treatment effect was greatest for the extremely obese patients treated for spondylolisthesis and disc herniation, largely due to the much poorer outcomes of nonsurgical management. The reanalysis of the SPORT suggests that the BMI of the highly obese patients (≥ 35 kg/m2) may have played a significant role in the differences originally observed between obese patients (BMI ≥ 30 kg/m2) and nonobese (BMI < 30 kg/m2) patients.[10]