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Cut-off Value for Body Mass Index in Predicting Surgical Success in Patients with Lumbar Spinal Canal Stenosis

STUDY DESIGN: Case-control. PURPOSE: To determine optimal cut-off value for body mass index (BMI) in predicting surgical success in patients with lumbar spinal canal stenosis (LSCS). OVERVIEW OF LITERATURE: BMI is an essential variable in the assessment of patients with LSCS. METHODS: We conducted a...

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Autores principales: Azimi, Parisa, Yazdanian, Taravat, Shahzadi, Sohrab, Benzel, Edward C., Azhari, Shirzad, Nayeb Aghaei, Hossein, Montazeri, Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284129/
https://www.ncbi.nlm.nih.gov/pubmed/30322247
http://dx.doi.org/10.31616/asj.2018.12.6.1085
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author Azimi, Parisa
Yazdanian, Taravat
Shahzadi, Sohrab
Benzel, Edward C.
Azhari, Shirzad
Nayeb Aghaei, Hossein
Montazeri, Ali
author_facet Azimi, Parisa
Yazdanian, Taravat
Shahzadi, Sohrab
Benzel, Edward C.
Azhari, Shirzad
Nayeb Aghaei, Hossein
Montazeri, Ali
author_sort Azimi, Parisa
collection PubMed
description STUDY DESIGN: Case-control. PURPOSE: To determine optimal cut-off value for body mass index (BMI) in predicting surgical success in patients with lumbar spinal canal stenosis (LSCS). OVERVIEW OF LITERATURE: BMI is an essential variable in the assessment of patients with LSCS. METHODS: We conducted a prospective study with obese and non-obese LSCS surgical patients and analyzed data on age, sex, duration of symptoms, walking distance, morphologic grade of stenosis, BMI, postoperative complications, and functional disability. Obesity was defined as BMI of ≥30 kg/m(2). Patients completed the Oswestry Disability Index (ODI) questionnaire before surgery and 2 years after surgery. Surgical success was defined as ≥30% improvement from the baseline ODI score. Receiver operating characteristic (ROC) analysis was used to estimate the optimal cut-off values of BMI to predict surgical success. In addition, correlation was assessed between BMI and stenosis grade based on morphology as defined by Schizas and colleague in total, 189 patients were eligible to enter the study. RESULTS: Mean age of patients was 61.5±9.6 years. Mean follow-up was 36±12 months. Most patients (88.4%) were classified with grades C (severe stenosis) and D (extreme stenosis). Post-surgical success was 85.7% at the 2-year follow-up. A weak correlation was observed between morphologic grade of stenosis and BMI. Rates of postoperative complications were similar between patients who were obese and those who were non-obese. Both cohorts had similar degree of improvement in the ODI at the 2-year follow-up. However, patients who were non-obese presented significantly higher surgical success than those who were obese. In ROC curve analysis, a cut-off value of ≤29.1 kg/m(2) for BMI in patients with LSCS was suggestive of surgical success, with 81.1% sensitivity and 82.2% specificity (area under the curve, 0.857; 95% confidence interval, 0.788–0.927). CONCLUSION: This study showed that the BMI can be considered a parameter for predicting surgical success in patients with LSCS and can be useful in clinical practice.
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spelling pubmed-62841292018-12-20 Cut-off Value for Body Mass Index in Predicting Surgical Success in Patients with Lumbar Spinal Canal Stenosis Azimi, Parisa Yazdanian, Taravat Shahzadi, Sohrab Benzel, Edward C. Azhari, Shirzad Nayeb Aghaei, Hossein Montazeri, Ali Asian Spine J Clinical Study STUDY DESIGN: Case-control. PURPOSE: To determine optimal cut-off value for body mass index (BMI) in predicting surgical success in patients with lumbar spinal canal stenosis (LSCS). OVERVIEW OF LITERATURE: BMI is an essential variable in the assessment of patients with LSCS. METHODS: We conducted a prospective study with obese and non-obese LSCS surgical patients and analyzed data on age, sex, duration of symptoms, walking distance, morphologic grade of stenosis, BMI, postoperative complications, and functional disability. Obesity was defined as BMI of ≥30 kg/m(2). Patients completed the Oswestry Disability Index (ODI) questionnaire before surgery and 2 years after surgery. Surgical success was defined as ≥30% improvement from the baseline ODI score. Receiver operating characteristic (ROC) analysis was used to estimate the optimal cut-off values of BMI to predict surgical success. In addition, correlation was assessed between BMI and stenosis grade based on morphology as defined by Schizas and colleague in total, 189 patients were eligible to enter the study. RESULTS: Mean age of patients was 61.5±9.6 years. Mean follow-up was 36±12 months. Most patients (88.4%) were classified with grades C (severe stenosis) and D (extreme stenosis). Post-surgical success was 85.7% at the 2-year follow-up. A weak correlation was observed between morphologic grade of stenosis and BMI. Rates of postoperative complications were similar between patients who were obese and those who were non-obese. Both cohorts had similar degree of improvement in the ODI at the 2-year follow-up. However, patients who were non-obese presented significantly higher surgical success than those who were obese. In ROC curve analysis, a cut-off value of ≤29.1 kg/m(2) for BMI in patients with LSCS was suggestive of surgical success, with 81.1% sensitivity and 82.2% specificity (area under the curve, 0.857; 95% confidence interval, 0.788–0.927). CONCLUSION: This study showed that the BMI can be considered a parameter for predicting surgical success in patients with LSCS and can be useful in clinical practice. Korean Society of Spine Surgery 2018-12 2018-10-16 /pmc/articles/PMC6284129/ /pubmed/30322247 http://dx.doi.org/10.31616/asj.2018.12.6.1085 Text en Copyright © 2018 by Korean Society of Spine Surgery This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Azimi, Parisa
Yazdanian, Taravat
Shahzadi, Sohrab
Benzel, Edward C.
Azhari, Shirzad
Nayeb Aghaei, Hossein
Montazeri, Ali
Cut-off Value for Body Mass Index in Predicting Surgical Success in Patients with Lumbar Spinal Canal Stenosis
title Cut-off Value for Body Mass Index in Predicting Surgical Success in Patients with Lumbar Spinal Canal Stenosis
title_full Cut-off Value for Body Mass Index in Predicting Surgical Success in Patients with Lumbar Spinal Canal Stenosis
title_fullStr Cut-off Value for Body Mass Index in Predicting Surgical Success in Patients with Lumbar Spinal Canal Stenosis
title_full_unstemmed Cut-off Value for Body Mass Index in Predicting Surgical Success in Patients with Lumbar Spinal Canal Stenosis
title_short Cut-off Value for Body Mass Index in Predicting Surgical Success in Patients with Lumbar Spinal Canal Stenosis
title_sort cut-off value for body mass index in predicting surgical success in patients with lumbar spinal canal stenosis
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284129/
https://www.ncbi.nlm.nih.gov/pubmed/30322247
http://dx.doi.org/10.31616/asj.2018.12.6.1085
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