{"title":"肥胖对腰椎间盘突出症的影响","authors":"Murtaza Ahmed Khan","doi":"10.35787/jimdc.v12i2.934","DOIUrl":null,"url":null,"abstract":"Background: Prevalence of obesity is increasing worldwide and obese patients constitute a major portion of the spinal surgeon s practice. The patients with lumbar disc herniation present the most in the outpatient department of neurosurgery. Obesity not only leads to the disc herniation but also causes a surgeon a difficult ordeal while operating as it leads to more peri operative complications than normal weight patients. This cross-sectional study was planned to see the impact of obesity on lumbar disc herniation and its association with disease outcome. \nMethodology This study was conducted in the department of neurosurgery at Sir Ganga Ram Hospital/ Fatima Jinnah Medical University (N=604; Males: n=368 Females: n=236) from December 15th 2021 to July 31st 2022. From the prospective registry, patients undergoing unilateral fenestration and discectomy, bilateral partial laminectomy and discectomy, and endoscopic discectomy were identified with complete BMI data. \nResults: In total 604 patients, 368 were males and 236 were females, with age range 25-55 years with ± 4.9 SD. Among these 187 (30.9%) were managed surgically while 417 (69.1%) patients were managed conservatively, which were assessed on VAS (Visual Analogue Score) and Sciatica Bothersomeness Index (SBI). Among them 87 patients (20.8%) patients were of normal weight, 145 (34.77%) were overweight and 185 (44.36%) were obese. Among187 patients who underwent surgery; 74 (39.5%) underwent unilateral fenestration and discectomy, 113 (60.4%) underwent bilateral partial laminectomy and discectomy whereas 16 patients (8.5%) underwent endoscopic discectomy. Lumber Disc Herniation (LDH) was more frequent in obese and overweight individuals than in normal-weight patients. \nConclusion It was observed that in obese and overweight patients, the severity of pain was more as compared to normal patients. Higher the BMI more the excruciating pain and more neurological were seen with increasing trend of numbness and radiculopathy. Hence, obesity may have a robust impact on lumbar disc herniation apart from other pathologies involved. \nKey words: Discectomy, Disc herniation, Laminectomy, Lumbar region, Obesity.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Obesity on Lumbar Disc Herniation\",\"authors\":\"Murtaza Ahmed Khan\",\"doi\":\"10.35787/jimdc.v12i2.934\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Prevalence of obesity is increasing worldwide and obese patients constitute a major portion of the spinal surgeon s practice. The patients with lumbar disc herniation present the most in the outpatient department of neurosurgery. Obesity not only leads to the disc herniation but also causes a surgeon a difficult ordeal while operating as it leads to more peri operative complications than normal weight patients. This cross-sectional study was planned to see the impact of obesity on lumbar disc herniation and its association with disease outcome. \\nMethodology This study was conducted in the department of neurosurgery at Sir Ganga Ram Hospital/ Fatima Jinnah Medical University (N=604; Males: n=368 Females: n=236) from December 15th 2021 to July 31st 2022. From the prospective registry, patients undergoing unilateral fenestration and discectomy, bilateral partial laminectomy and discectomy, and endoscopic discectomy were identified with complete BMI data. \\nResults: In total 604 patients, 368 were males and 236 were females, with age range 25-55 years with ± 4.9 SD. Among these 187 (30.9%) were managed surgically while 417 (69.1%) patients were managed conservatively, which were assessed on VAS (Visual Analogue Score) and Sciatica Bothersomeness Index (SBI). Among them 87 patients (20.8%) patients were of normal weight, 145 (34.77%) were overweight and 185 (44.36%) were obese. Among187 patients who underwent surgery; 74 (39.5%) underwent unilateral fenestration and discectomy, 113 (60.4%) underwent bilateral partial laminectomy and discectomy whereas 16 patients (8.5%) underwent endoscopic discectomy. Lumber Disc Herniation (LDH) was more frequent in obese and overweight individuals than in normal-weight patients. \\nConclusion It was observed that in obese and overweight patients, the severity of pain was more as compared to normal patients. Higher the BMI more the excruciating pain and more neurological were seen with increasing trend of numbness and radiculopathy. Hence, obesity may have a robust impact on lumbar disc herniation apart from other pathologies involved. \\nKey words: Discectomy, Disc herniation, Laminectomy, Lumbar region, Obesity.\",\"PeriodicalId\":33701,\"journal\":{\"name\":\"Journal of Islamabad Medical and Dental College\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-07-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Islamabad Medical and Dental College\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.35787/jimdc.v12i2.934\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Islamabad Medical and Dental College","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.35787/jimdc.v12i2.934","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:肥胖的患病率在世界范围内不断增加,肥胖患者构成了脊柱外科手术的主要部分。腰椎间盘突出症患者以神经外科门诊最多。肥胖不仅会导致椎间盘突出,而且与正常体重的患者相比,肥胖患者的围手术期并发症更多,手术过程也会非常艰难。本横断面研究旨在观察肥胖对腰椎间盘突出症的影响及其与疾病预后的关系。本研究在Sir Ganga Ram医院/法蒂玛真纳医科大学神经外科进行(N=604;从2021年12月15日到2022年7月31日,男性:n=368女性:n=236。从前瞻性登记中,接受单侧开窗和椎间盘切除术、双侧部分椎板切除术和椎间盘切除术以及内窥镜椎间盘切除术的患者被确定为具有完整的BMI数据。结果:共604例患者,其中男性368例,女性236例,年龄25 ~ 55岁,SD±4.9。其中手术治疗187例(30.9%),保守治疗417例(69.1%),采用视觉模拟评分(VAS)和坐骨神经痛困扰指数(SBI)进行评估。其中体重正常87例(20.8%),超重145例(34.77%),肥胖185例(44.36%)。187例接受手术的患者中;74例(39.5%)行单侧开窗椎间盘切除术,113例(60.4%)行双侧部分椎板切除术和椎间盘切除术,16例(8.5%)行内窥镜椎间盘切除术。腰椎间盘突出症(LDH)在肥胖和超重个体中比在正常体重患者中更常见。结论肥胖和超重患者的疼痛程度明显高于正常患者。体重指数越高,剧烈疼痛和神经性疼痛越严重,麻木和神经根病呈增加趋势。因此,除了涉及的其他病理外,肥胖可能对腰椎间盘突出症有强烈的影响。关键词:椎间盘切除术,椎间盘突出,椎板切除术,腰椎区,肥胖。
Background: Prevalence of obesity is increasing worldwide and obese patients constitute a major portion of the spinal surgeon s practice. The patients with lumbar disc herniation present the most in the outpatient department of neurosurgery. Obesity not only leads to the disc herniation but also causes a surgeon a difficult ordeal while operating as it leads to more peri operative complications than normal weight patients. This cross-sectional study was planned to see the impact of obesity on lumbar disc herniation and its association with disease outcome.
Methodology This study was conducted in the department of neurosurgery at Sir Ganga Ram Hospital/ Fatima Jinnah Medical University (N=604; Males: n=368 Females: n=236) from December 15th 2021 to July 31st 2022. From the prospective registry, patients undergoing unilateral fenestration and discectomy, bilateral partial laminectomy and discectomy, and endoscopic discectomy were identified with complete BMI data.
Results: In total 604 patients, 368 were males and 236 were females, with age range 25-55 years with ± 4.9 SD. Among these 187 (30.9%) were managed surgically while 417 (69.1%) patients were managed conservatively, which were assessed on VAS (Visual Analogue Score) and Sciatica Bothersomeness Index (SBI). Among them 87 patients (20.8%) patients were of normal weight, 145 (34.77%) were overweight and 185 (44.36%) were obese. Among187 patients who underwent surgery; 74 (39.5%) underwent unilateral fenestration and discectomy, 113 (60.4%) underwent bilateral partial laminectomy and discectomy whereas 16 patients (8.5%) underwent endoscopic discectomy. Lumber Disc Herniation (LDH) was more frequent in obese and overweight individuals than in normal-weight patients.
Conclusion It was observed that in obese and overweight patients, the severity of pain was more as compared to normal patients. Higher the BMI more the excruciating pain and more neurological were seen with increasing trend of numbness and radiculopathy. Hence, obesity may have a robust impact on lumbar disc herniation apart from other pathologies involved.
Key words: Discectomy, Disc herniation, Laminectomy, Lumbar region, Obesity.