Influence Of Obesity On Short-team Clinical Efficacy And Complications Of OLIF

Objective In the early stage of OLIF,obesity became a contraindication to OLIF due to lack of exposure device and unfamiliar anatomy.Now,with the innovation of access devices and the improvement of surgical techniques,it is not clear whether obesity will affect the incidence of complications and clinical efficacy of OLIF.The purpose of this study is to explore the Influence of Obesity on Short-team Clinical Efficacy and Complications of OLIF.Methods The authors performed a retrospective study on 136 patients who underwent OLIF at the same hospital between January 1,2017 and January1,2019.Patients were categorized according to their body mass index.Obesity was defined as a BMI≥28kg/m~2,and non-obesity was defined as a BMI<28kg/m~2.The data collected included demographic variables,Operation time,blood loss,VAS score,ODI index,complications,and fusion rate after operation.Results Among 136 patients,there were no significant differences in gender,age and bone density between the obese and non-obese groups.In this study,the obese group and non obese group were divided into three groups: total,L5-S1 fusion group and no L5-S1 fusion group.The intraoperative and postoperative complications were compared.The VAS score and ODI index of the two groups were significantly improved 6months after operation(P < 0.05),There was no significant difference in operation time,blood loss,VAS score and ODI index and fusion rate 6months after operation(P > 0.05).The overall incidence of complications was 21.74% in the obese group and 12.22% in the non-obese group.The incidence of complications in the obese group(no L5-S1 fusion)was17.14%,that in the non-obese group(no L5-S1 fusion)was 9.25%.There was no significant difference in the part.(P>0.05).The incidence of complications in the obese group(L5-S1 fusion)was 45.45%,that in the non-obese group(L5-S1 fusion)was 13.04%,showing significant difference between groups(P <0.05).There were 11 cases of intraoperative complications and 2 cases of postoperative complications in obesity group,2 cases of intraoperative complications and 9 cases of postoperative complications in non obesity group.There was no significant difference between the two groups(P>0.05).Conclusion Obesity does not increase the operative time,blood loss,overall incidence of complications,fusion rate and symptom improvement in OLIF compared with non-obese patients.there were no significant differences in intraoperative and postoperative complications.However,if the surgical segment includes the L5-S1 segment,obese patients do have a higher incidence of complications,and patients should be fully informed of the increased risk of complications before the operation and carefully consider the surgical approach.