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Spinal Fusion Procedure Safe in Obese Patients

Extreme lateral interbody fusion not associated with increased early complications

MONDAY, Aug. 9 (HealthDay News) -- Obese patients undergoing extreme lateral interbody fusion (XLIF) for degenerative disease of the lumbar and thoracic spine do not have more complications than non-obese patients who undergo the procedure, according to research published in the August issue of the Journal of Spinal Disorders & Techniques.

William B. Rodgers, M.D., of Spine Midwest Inc. in Jefferson City, Mo., and colleagues conducted a retrospective review of prospective data from 313 patients (156 obese, 157 non-obese) who had undergone an XLIF procedure between October 2006 and July 2008. The objective of the study was to compare the incidence of early complications, and predictors of complications, for obese and non-obese patients.

The researchers found that the obese and non-obese groups were similar regarding age, prior surgeries, comorbidities, and diagnoses. There were no transfusions or infections in either group. Complications were all considered to be mild and were about the same in each group. Diagnosis was the only variable that had a significant association with the risk of complications, with higher complication rates noted in patients with a primary diagnosis of degenerative disk disease and recurrent disk herniation, compared to those with diagnoses of stenosis and spondylolisthesis.

"Traditional teachings about spinal fusion in the obese is, in our opinion, derivative of the limitations of traditional techniques as much as the technical limitations imposed by the patients' constitutional habitus," the authors write. "Our experience demonstrates the safety of this minimally invasive spine surgery technique -- XLIF -- in treating obese patients. Proper positioning, reliable automated neurological monitoring and fluoroscopic guidance, and meticulous attention to operative technique are required, but, when these caveats are acknowledged, the early outcomes compare well with traditional interventions."

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