000			03819nam a22004097a 4500
008			241030s20242024 xxu||||| |||| 00| 0 eng d
022			_a2380-0186
024			_a01933606-990000000-00347 [pii]
040			_aOvid MEDLINE(R)
099			_a39132871
245			_aNo Increased Risk of All-cause Revision up to 10 Years in Patients Who Underwent Bariatric Surgery Before Single-level Lumbar Fusion.
251			_aClinical Spine Surgery : A Spine Publication. 2024 Aug 12
252			_aClin Spine Surg. 2024 Aug 12
253			_aClinical spine surgery
260			_c2024
260			_fFY2025
260			_p2024 Aug 12
265			_saheadofprint
265			_tPublisher
266			_d2024-10-30
266			_z2024/08/12 08:03
520			_aBACKGROUND: Obesity accelerates degenerative spine processes, often necessitating lumbar fusion for functional improvement. BS is explored for weight loss in lumbar spine cases, but its impact on fusion outcomes remains unclear. Existing literature on BS before lumbar fusion yields conflicting results, with a limited investigation into long-term spine complications.
520			_aCONCLUSIONS: Prior BS did not elevate the 10-year all-cause revision risk in lumbar fusion compared with the general population or morbidly obese patients. However, patients who underwent BS were associated with a lower 10-year risk of I&D when compared with morbidly obese patients without BS. Our study indicates comparable long-term surgical complication rates between patients who underwent BS and these control groups, with an associated reduction in risk of infectious complications when compared with morbidly obese patients. Although BS may address medical comorbidities, its impact on long-term lumbar fusion revision outcomes is limited. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
520			_aMETHODS: Utilizing the PearlDiver database, we examined patients undergoing elective primary single-level lumbar fusion, categorizing them by prior BS. Propensity score matching created cohorts from (1) the general population without BS history and (2) morbidly obese patients without BS history. Using Kaplan-Meier and Cox proportional hazard modeling, we compared 10-year cumulative incidence rates and hazard ratios (HRs) for all-cause revision and specific revision indications.
520			_aOBJECTIVE: This study aimed to assess whether prior bariatric surgery (BS) is associated with higher 10-year surgical complication and revision rates in lumbar spine fusion compared with the general population and morbidly obese patients.
520			_aRESULTS: Patients who underwent BS exhibited a higher cumulative incidence and risk of decompressive laminectomy and irrigation & debridement (I&D) within 10 years postlumbar fusion compared with matched controls from the general population [decompressive laminectomy: HR = 1.32; I&D: HR = 1.35]. Compared with matched controls from a morbidly obese population, patients who underwent BS were associated with lower rates of adjacent segment disease (HR = 0.31) and I&D (HR = 0.64). However, the risk of all-cause revision within 10 years did not increase for patients who underwent BS compared with matched or unmatched controls from the general population or morbidly obese patients (P > 0.05).
520			_aSTUDY DESIGN: Retrospective cohort study.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Washington Hospital Center
656			_aOrthopedic Surgery
657			_aJournal Article
700			_aMesfin, Addisu _bMWHC
790			_aKuyl EV, Gupta A, Parel PM, Quan T, Patel TC, Mesfin A
856			_uhttps://dx.doi.org/10.1097/BSD.0000000000001669 _zhttps://dx.doi.org/10.1097/BSD.0000000000001669
942			_cART _dArticle
999			_c14697 _d14697