Assessment of Obesity as Risk Factor of Lumbar Disc Surgery: Retrospective Analysis of 598 Cases and Simulated Surgery on 3D-Printed Models

医学 肥胖 体质指数 外科 并发症 风险因素 腰椎 回顾性队列研究 腰椎间盘突出症 内科学
作者
Ralf Stroop,Fernando Carballar,Samer Zawy Alsofy,Hraq Mourad Sarkis,Makoto Nakamura,Christoph Greiner,Bernhard Dorweiler,Moritz Wegner
出处
期刊:Journal of Clinical Medicine [MDPI AG]
卷期号:13 (14): 4193-4193
标识
DOI:10.3390/jcm13144193
摘要

(1) Background: Obesity poses known risks in surgery, including a prolonged operation time and postoperative complications. Given the rising obesity rates and frequent lumbar disc surgeries, understanding these risks is crucial. This study aims to assess the impact of obesity on operation duration and postoperative complications in lumbar disc prolapse surgery. (2) Methods: We retrospectively analyzed 598 patients with monosegmental disc herniation, correlating their body mass index (BMI) as a surrogate parameter for obesity with operation time. Excluding complex cases (multi-segmental herniations or recurrent herniations), complication rates and hospital stays were recorded. Simulated surgeries on 3D-printed models of varying obesity levels examined operation times and instrument suitability. (3) Results: Of these patients, 438 patients had a BMI of <30, and 160 patients had a BMI of ≥30. Complication rates showed no significant differences between groups. Linear regression analysis failed to establish a sole dependency of operation time on BMI, with R2 = 0.039 for the normal-weight group (BMI < 30) and R2 = 0.059 for the obese group (BMI ≥ 30). The simulation operations on the 3D-printed models of varying degrees of obesity showed a significant increase in the simulated operation time with higher levels of obesity. A geometrically inadequate set of surgical instruments was assumed to be a significant factor in the simulated increase in operating time. (4) Conclusions: While various factors influence operation time, obesity alone does not significantly increase it. However, simulated surgeries highlighted the impact of obesity, particularly on instrument limitations. Understanding these complexities is vital for optimizing surgical outcomes in obese patients.
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