Thursday, 31 October 2013

Obesity and Spinal Disc Herniation

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. How to calculate your BMI index
BMI= weight (kg)/ height (m2)

C. Spinal Disc Herniation
Vertebal Disc Herniation is defined as a condition that affect the spine as a result of the fiber torn of outer ring of disc which form the spinal core, putting pressure on the spinal nerves, that can lead to radiculopathy. According to statistic Spinal Disc Herniation occurs most often people in their 30s and 40s.


D. How Obesity associates with Spinal Disc Herniation
1. According to the study of "Lumbosacral radiculopathy--factors effects on it's severity" by Tomić S, Soldo-Butković S, Kovac B, Faj D, Jurić S, Misević S, Knezević L, Vukasinović D, posted in PubMed, researchers found that Obese patients, males, elderly patients, and patients doing physically intensive jobs are at a bigger risk of suffering from severe radiculopathy. Diabetes mellitus, arterial hypertension, and hyperlipidemia do not influence the severity of lumbosacral radiculopathy.Link
2. In a study of "Obesity and spine surgery: relation to perioperative complications", by Patel N, Bagan B, Vadera S, Maltenfort MG, Deutsch H, Vaccaro AR, Harrop J, Sharan A, Ratliff JK., posted in PubMed, researchers found that Obesity is a prevalent condition in patients undergoing elective fusion for degenerative spinal conditions and may increase the prevalence and incidence of perioperative complications. In their analysis, the authors correlated increasing BMI and increased risk of significant postoperative complications. The correlation of obesity and perioperative complications may assist in the preoperative evaluation and selection of patients for surgery.

3. In the abstract of the study of "Epidural lipomatosis with lumbar radiculopathy in one obese patient. Case report and review of the literature" by Qasho R, Ramundo OE, Maraglino C, Lunardi P, Ricci G., posted in PubMed, researchers indicated that 8 obese patients with idiopathic epidural spinal lipomatosis described in the literature, 3 were treated conservatively, with complete regression of symptoms in 2 cases, partial in the other one. In our patient, the radicular symptomatology disappeared once he had lost weight.

4. According to the study of "Back disorders (low back pain, cervicobrachial and lumbosacral radicular syndromes) and some related risk factors" by Kostova V, Koleva M., posted in PubMed, researchers found that There is an interesting trend in the case of combined impact of age and gender among men and women of 40 or under and over 40--the risk, estimated by OR, is higher. In men over 40, overweight, obesity and heaviness of smoking, estimated by duration of smoking and daily cigarette consumption (more than 20 years and more than 20 cigarettes per day), increase the risk of developing back disorders (BD).

5. Etc.

E. Treatments of Obesity and Spinal Disc Herniation
1. According to the study of "Spine surgery in morbidly obese patients" by Telfeian AE, Reiter GT, Durham SR, Marcotte P. posted in PubMed, researchers found The authors found that although morbidly obese patients may present late in the course of their symptoms and require modifications in the use of standard neuroimaging, operative facilities, and treatment plans, open mindedness and persistence can yield satisfactory results in most cases.

2. In a study of "Obesity and spine surgery: reassessment based on a prospective evaluation of perioperative complications in elective degenerative thoracolumbar procedures" by Yadla S, Malone J, Campbell PG, Maltenfort MG, Harrop JS, Sharan AD, Vaccaro AR, Ratliff JK., posted in PubMed, researchers found that This prospective assessment of perioperative complications in elective degenerative thoracolumbar procedures shows no relationship between patient BMI and the incidence of perioperative minor or major complications. Specific care in perioperative positioning may limit the risk of perioperative positioning palsies in obese patients.

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