Bariatric Surgery Before Lumbar Fusion Lacks the Hoped-for Benefit

Only about one in four patients reduced BMI < 35, and those who did not remained at risk for complications

Bariatric Surgery Before Lumbar Fusion Lacks the Hoped-for Benefit

What’s the Claim?

A large-database study exploring the interaction of morbid obesity, bariatric surgery, and posterior lumbar spine fusion found:

  • More than 70% of patients who had bariatric surgery for morbid obesity in advance of lumbar fusion remained morbidly obese at the time of lumbar fusion
    • Only 27% reduced their body mass index below 35 kg/m2.
    • Interestingly, about 2.3% of patients had bariatric surgery before lumbar spine surgery.
  • Those who reduced their BMI below 35 kg/m2 with bariatric surgery reduced their odds of severe adverse events within 90 days of lumbar fusion compared to those who remained in the morbidly obese category (odds ratio 0.5 [95% CI 0.3 to 0.9]).
    • The authors defined severe events as one or more of the following: surgical site infection, sepsis, DVT, PE, MI, or cardiac arrest.
  • Those whose BMIs remained ≥ 35 kg/m2 did not experience any reduction in the odds of complications.

How’s It Stack Up?