Effects of Body Mass Index on Spondylolisthesis Surgery and Associated Patient-Reported Outcomes: A Retrospective Review

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Figure 1
Study flow chart.
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Figure 2
Visual analog scale scores for all body mass index (BMI) categories. (A) Entire cohort. (B) Degenerative cohort. (C) Isthmic cohort.
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Figure 3
Oswestry Disability Index scores for all body mass index (BMI) categories. (A) Entire cohort. (B) Degenerative cohort. (C) Isthmic cohort.

Table 1

Patient and characteristics and surgical outcomes (N = 86).

Characteristic	n (%)
Sex
Female	50 (58.1%)
Male	36 (41.9%)
BMI
<30	40 (46.5%)
30–34.9	25 (29.1%)
35–39.9	15 (17.4%)
≥40	6 (7.0%)
Mean ± SD	30.63 ± 6.99
Surgical Approach and BMI
TLIF
<30	21 (56.8%)
30–34.9	9 (24.3%)
35–39.9	6 (16.2%)
≥40	1 (2.7%)
Mean ± SD	28.55 ± 6.75
LLIF
<30	9 (25.7%)
30–34.9	14 (40.0%)
35–39.9	8 (22.9%)
≥40	4 (11.4%)
Mean ± SD	33.63 ± 5.97
ALIF
<30	7 (70%)
30–34.9	1 (10%)
35–39.9	1 (10%)
≥40	1 (10%)
Mean ± SD	28.53 ± 9.02
OLIF
<30	0
30–34.9	2 (100%)
35–39.9	0
≥40	0
Mean ± SD	32.85 ± 1.06
Multi-approach
<30	3 (75%)
30–34.9	1 (25%)
35–39.9	0
≥40	0
Mean ± SD	28.85 ± 3.44
Prior Lumbar Fusion
Yes	3 (3.5%)
No	83 (96.5%)
History of Degenerative Disk Disease
Yes	8 (9.3%)
No	78 (90.7%)
Type of Surgery
TLIF	37 (43.0%)
LLIF	33 (38.4%)
ALIF	10 (11.6%)
OLIF	2 (2.3%)
Multiple	4 (4.7%)
Segment Level
L3–4	9 (10.5%)
L4–5	44 (51.2%)
L5–S1	14 (16.3%)
Multilevel	19 (22.1%)
Spondylolisthesis
Grade 1	56 (73.7%)
Grade 2	20 (26.3%)
Grade 3	0
Grade 4	0
Grade 5	0
VAS
0, none	8 (9.3%)
1–3, mild	9 (10.5%)
4–6, moderate	23 (26.7%)
7–10, severe	46 (53.5%)
Mean ± SD	5.85 ± 2.83
ODI
0–20, minimal	6 (7.0%)
21–40, moderate	18 (20.9%)
41–60, severe	46 (53.5%)
61–80, crippled	16 (18.6%)
81–100, bedbound	0
Mean ± SD	47.81 ± 16.32

Abbreviations: ALIF, anterior lumbar interbody fusion; BMI, body mass index; LLIF, lateral lumbar interbody fusion; ODI, Oswestry Disability Index; TLIF, transforaminal lumbar interbody fusion; VAS, visual analog scale.
Note: Data presented as n (%) unless otherwise noted.

Table 4

Mean change in VAS and ODI scores for each BMI category.

Abbreviations: BMI, body mass index ; MCID, minimal clinically important distance; ODI, Oswestry Disability Index; VAS, visual analog scale.
↵a Met MCID.

Table 5

Patient characteristics for the type of spondylolisthesis.

Table 8

Return to the operating room, imaging modality, and surgical approach distribution.

Variable	n (%)
Return to OR
Yes	8 (9.3%)
No	78 (90.7%)
Imaging used
Radiography	79 (91.0%)
Computed tomography	55 (64.0%)
Magnetic resonance imaging	9 (10.5%)
Surgical approach for patients who returned to OR
LLIF	4 (50%)
TLIF	3 (37.5%)
ALIF	1 (12.5%)
BMI, mean ± SD
Returned to OR	34.9 ± 5.07
No return to OR	30.1 ± 6.89

Abbreviations: ALIF, anterior lumbar interbody fusion; BMI, body mass index; LLIF, lateral lumbar interbody fusion; OR, operating room; TLIF, transforaminal lumbar interbody fusion.