Many physicians suggest that obese patients who are candidates for lumbar fusion surgery pursue a weight loss program prior to their surgery in order to improve their overall health.
A new study conducted by a researcher from the Montefiore Medical Center has refined that recommendation.
Though Woojin Cho agrees that patients need to take steps to improve their overall health, the recent study that he presented at the 25th International Meeting on Advanced Spine Techniques suggests that when patients go so far as to pursue rapid weight loss through bariatric weight loss surgery, it puts them at greater risk for complications from lumbar fusion surgery.
He concludes that spinal surgeons should avoid recommending bariatric surgery to obese patients prior to the procedure.
In conducting the retrospective study, the researchers compared outcomes in patients who had undergone the surgery between 2005 and 2015 and whose data was available on the National Surgical Quality Improvement Program (NSQIP) dataset.
The almost-40,000 patients were broken down statistically based on whether they had achieved a 10% weight loss in the six months before their surgery and matched with patients who were similar to them in key characteristics, including their Body Mass Index.
The researchers then based their conclusions about rate of post-surgery complications on the patients’ length of hospital stay and the occurrence of deep vein thrombosis or surgical site infections. They found that the group that had undergone dramatic weight loss following surgery had hospital stays that were nearly twice as long, had more than twice as many infections, and far more deep vein thrombosis diagnoses.
Though it is generally accepted that we are healthier when we weight less, and that less weight on our frame provides less stress on the spine, but in the case of surgical procedures, Cho’s study and its statistics suggest that the weight loss surgery has a negative impact on the body’s healing process.
That impact, Cho concludes, is a result of deficiencies in the body’s macro and micronutrient stores.
Bariatric weight loss surgery not only shrinks the size of the stomach and reduces the amount of food that a person is able to take in: it can also have an impact on the body’s ability to absorb key nutrients that play an important role in healing. These nutrients include protein, Vitamins A, D, B6 and B12, folate, zinc and iron.
Though Cho suggests that the next logical step is to study the impact of providing nutritional supplementation following bariatric surgery and before lumbar fusion surgery.
One way or another, if you are a patient who has a significant amount of weight to lose and you are considering undergoing lumbar fusion surgery or any other spinal procedure, our lumbar spine specialist will meet with you and provide a personalized care plan that will maximize your healing and provide you with the pain relief that you need. Contact us today to set up a consultation.