Obesity does not affect the outcome of full-endoscopic lumbar discectomy interlaminar approach

Abstract

Introduction: Obesity is a risk factor of complications in spine surgery, but its detailed association with full-endoscopic discectomy (FED) is unknown.

Methods: Subjects were the patients who underwent FED-interlaminar (IL) approach at the L4/5 or L5/S1 level in our institution between January 2020 and June 2022. Body mass index (BMI), body surface-disc distance, operative time, facet joint preservation rate, and complication rate were evaluated and compared among three groups: BMI≤20 (group T), 22≤BMI≤28 (group C), and BMI≤30 (group O).

Results: A total of 264 patients were included in this study; and 30, 188, and 31 patients were included in group T, C, and O, respectively. There was no significant correlation between BMI or body surface-disc distance and operative time or joint preservation rate. No dural injury, hematoma, or infection occurred in this study. In group O, although diabetes prevalence was higher (35%), complication rate or hospital stay did not increase. In group T, C, and O, there were no significant differences in pain VAS improvement rates (81% vs. 77% vs. 78%), lumbar spine JOA score improvement rates (87% vs. 85% vs. 88%), or revision surgery rates (3% vs. 8% vs. 6%).

Conclusions: FED-IL approach was a useful treatment in obese lumbar disc herniation patients.