CORRELATION BETWEEN OBESITY, SAGITTAL BALANCE AND CLINICAL OUTCOME IN SPINAL FUSION

Objective:To correlate obesity with radiographic parameters of spinal and spinopelvic balance in patients undergoing spinal arthrodesis, and to correlate obesity with clinical outcome of these patients.Methods:Observational retrospective study including patients who underwent spinal arthrodesis, with minimum follow-up period of three months. We measured waist circumference, as well as height and weight to calculate body mass index (BMI) and obtained radiographs of the total column. The clinical parameters studied were pain by visual analog scale (VAS) and the Oswestry questionnaire (ODI). Obesity correlated with radiographic parameters of the sagittal and spinopelvic balance and postoperative clinical parameters.Results:32 patients were analyzed. The higher the BMI, the greater the value of VAS found, but without statistical significance (p=0.83). There was also no correlation between BMI and the ODI questionnaire. Analyzing the abdominal circumference, there was no correlation between the VAS and ODI. There was no correlation between BMI or waist circumference and the radiographic parameters of global spinopelvic sagittal alignment. Regarding the postoperative results, there was no correlation between the mean BMI and waist circumference and the postoperative results for ODI and VAS (p=0.75 and p=0.7, respectively).Conclusions:The clinical outcomes of patients who undergone spinal fusion were not affected by the BMI and waist circumference. Also, there was no correlation between radiographic parameters of spinal and spinopelvic sagittal balance with obesity in patients previously treated with arthrodesis of the spine.研究目的：探讨肥胖与接受脊柱融合术患者的脊柱及脊柱骨盆平衡影像学参数之间的相关性，并分析肥胖与该类患者的临床结局的关联。 研究方法：本研究为观察性回顾性研究，纳入接受脊柱融合术且随访时长至少3个月的患者。研究人员测量了患者的腰围、身高与体重，以计算体质量指数（BMI, Body Mass Index），并获取全脊柱影像学资料。本次研究考察的临床参数包括视觉模拟评分法（VAS, Visual Analog Scale）评估的疼痛程度以及奥斯威斯功能障碍指数问卷（ODI, Oswestry Disability Index）。分析肥胖与矢状位及脊柱骨盆平衡影像学参数、术后临床参数之间的相关性。 研究结果：本研究共纳入32例患者进行分析。体质量指数越高，视觉模拟评分值越高，但该差异无统计学意义（p=0.83）。体质量指数与奥斯威斯功能障碍指数问卷得分之间亦无相关性。分析腰围数据可见，腰围与VAS评分、ODI得分均无相关性。体质量指数或腰围与全脊柱骨盆矢状位序列的影像学参数之间亦无相关性。就术后结局而言，平均体质量指数与腰围分别与术后ODI及VAS评分均无相关性（分别对应p=0.75与p=0.7）。 研究结论：接受脊柱融合术患者的临床结局不受体质量指数及腰围的影响。此外，既往接受脊柱融合术的患者中，脊柱及脊柱骨盆矢状位平衡的影像学参数与肥胖程度并无相关性。