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Influence of Body Mass Index on Subjective and Objective Measures of Pain, Functional Impairment, and Health-Related Quality of Life in Lumbar Degenerative Disc Disease


Stienen, Martin N; Joswig, Holger; Smoll, Nicolas R; Corniola, Marco V; Schaller, Karl; Hildebrandt, Gerhard; Gautschi, Oliver P (2016). Influence of Body Mass Index on Subjective and Objective Measures of Pain, Functional Impairment, and Health-Related Quality of Life in Lumbar Degenerative Disc Disease. World Neurosurgery, 96:570-577.e1.

Abstract

OBJECTIVE To analyze the influence of body mass index (BMI) on subjective and objective measures of pain, functional impairment, and health-related quality of life in patients with lumbar degenerative disc disease undergoing surgery. METHODS Prospective institutional review board-approved 2-center study, measuring visual analog scale (VAS) back and leg pain, Roland-Morris Disability Index (RMDI), Oswestry Disability Index (ODI), EuroQol 5D questionnaire, and Short Form-12 at baseline, 6 weeks, 6 months, and 1 year postoperatively. T-scores of objective functional impairment (OFI) were determined using the Timed Up and Go (TUG) test. RESULTS A total of 375 patients with a median BMI of 26.6 kg/m(2) (94 obese patients [BMI ≥30 kg/m(2)]) were included. Obese patients presented more VAS back pain (mean, 4.7 vs. 3.6; P = 0.001) and greater disability on the RMDI (mean, 12.6 vs. 11.3; P = 0.045). The prevalence and severity of OFI were similar in obese and nonobese patients. There was a weak positive correlation between BMI and VAS back pain (r = 0.1552; P = 0.0026), on both RMDI (r = 0.1138; P = 0.0276) and ODI (r = 0.1075; P = 0.0374). There was no correlation between BMI and TUG T-scores (r = 0.0475; P = 0.3585). Obese patients were as likely as nonobese patients to show a positive 6-week treatment response, and the outcome up to 1 year was similar. CONCLUSIONS BMI positively correlates with VAS back pain, RMDI, and ODI. Standardized TUG T scores reflect the patient's degree of OFI well, irrespective of BMI. The TUG test appears to be a good means to estimate functional impairment in populations with a high prevalence of obesity.

Abstract

OBJECTIVE To analyze the influence of body mass index (BMI) on subjective and objective measures of pain, functional impairment, and health-related quality of life in patients with lumbar degenerative disc disease undergoing surgery. METHODS Prospective institutional review board-approved 2-center study, measuring visual analog scale (VAS) back and leg pain, Roland-Morris Disability Index (RMDI), Oswestry Disability Index (ODI), EuroQol 5D questionnaire, and Short Form-12 at baseline, 6 weeks, 6 months, and 1 year postoperatively. T-scores of objective functional impairment (OFI) were determined using the Timed Up and Go (TUG) test. RESULTS A total of 375 patients with a median BMI of 26.6 kg/m(2) (94 obese patients [BMI ≥30 kg/m(2)]) were included. Obese patients presented more VAS back pain (mean, 4.7 vs. 3.6; P = 0.001) and greater disability on the RMDI (mean, 12.6 vs. 11.3; P = 0.045). The prevalence and severity of OFI were similar in obese and nonobese patients. There was a weak positive correlation between BMI and VAS back pain (r = 0.1552; P = 0.0026), on both RMDI (r = 0.1138; P = 0.0276) and ODI (r = 0.1075; P = 0.0374). There was no correlation between BMI and TUG T-scores (r = 0.0475; P = 0.3585). Obese patients were as likely as nonobese patients to show a positive 6-week treatment response, and the outcome up to 1 year was similar. CONCLUSIONS BMI positively correlates with VAS back pain, RMDI, and ODI. Standardized TUG T scores reflect the patient's degree of OFI well, irrespective of BMI. The TUG test appears to be a good means to estimate functional impairment in populations with a high prevalence of obesity.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurosurgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:December 2016
Deposited On:02 Feb 2017 08:38
Last Modified:31 Mar 2017 07:14
Publisher:Elsevier
ISSN:1878-8750
Publisher DOI:https://doi.org/10.1016/j.wneu.2016.09.070
PubMed ID:27686509

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