Back pain and sagittal spine alignment in obese patients eligible for bariatric surgery
- 36 Downloads
The objective of this research was to evaluate the prevalence of cervical and lumbar pain in obese patients eligible for bariatric surgery and to investigate possible changes in sagittal spine alignment in these patients.
The following parameters were compared in 30 obese patients and a control group of 25 non-obese volunteers: body mass index, prevalence of cervical and lumbar pain assessed by visual analog scale (VAS), Neck Disability Index [NDI] and Oswestry Disability Index [ODI], as well as radiographic parameters of the spine and pelvis measured with Surgimap software.
The cervical and lumbar VAS and the NDI and ODI were significantly worse in obese patients. Compared with the control group, the cervical sagittal vertical axis (cSVA) of the obese group had higher variance (p value = 0.0025) and the cervical lordosis was diminished (p value = 0.0023). Thoracic kyphosis, lumbar lordosis, and the pelvic parameters were not significantly different between the groups.
Obese patients demonstrated lower functional performance compared with their non-obese counterparts, while cervical lordosis was diminished and the cSVA was increased in obese patients.
KeywordsObesity Neck pain Low back pain Sagittal alignment parameters Spinopelvic parameters
We thank Peter Mittwede, MD, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript. We thank Isabela Peixoto de Mello for drawing the figure representing the measures.
Alexandre Peixoto de Mello and Glaucus Cajaty dos Santos Martins designed the studies, analyzed data and wrote the manuscript. André Raposo Heringer and Raphael Barbosa Gamallo collected the data from the patients. Maurício de Pinho Gama revised the statistics. Luiz Felippe dos Santos Martins Filho, Antônio Vítor de Abreu and Antonio Carlos Pires Carvalho revised the analyzed data and the manuscript.
The study was performed using personal resources from the authors and exams performed at Hospital Federal de Ipanema as part of the pre-operative evaluation.
Compliance with ethical standards
Conflict of interest
The authors declare that there is no conflict of interest.
- 2.World Health Organization, WHO (2018) WHO Obesity and Overweight. In: World Health Organisation http://www.who.int/mediacentre/factsheets/fs311/en/. Accessed 14 Feb 2019
- 3.Dobbs R, Sawers C, Thompson F et al (2014) Overcoming obesity: an initial economic analysis. McKinsey Global Institute, New York CityGoogle Scholar
- 14.Terashima Y, Kakutani K, Yurube T et al (2016) Expression of adiponectin receptors in human and rat intervertebral disc cells and changes in receptor expression during disc degeneration using a rat tail temporary static compression model. J Orthop Surg Res 11:147. https://doi.org/10.1186/s13018-016-0481-z CrossRefGoogle Scholar
- 16.Di Cesare M, Bentham J, Stevens GA et al (2016) Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet 387:1377–1396. https://doi.org/10.1016/S0140-6736(16)30054-X CrossRefGoogle Scholar
- 20.Manchikanti L, Singh V, Datta S et al (2009) Comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician 12:E35–E70Google Scholar
- 28.World Health Organization (WHO) (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation, SwitzerlandGoogle Scholar
- 32.Roussouly P, Gollogly S, Berthonnaud E, Dimnet J (2005) Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine (Phila Pa 1976) 30:346–353. https://doi.org/10.1097/01.brs.0000152379.54463.65 CrossRefGoogle Scholar
- 37.Brooks C, Siegler JC, Cheema BS, Marshall PWM (2013) No relationship between body mass index and changes in pain and disability after exercise rehabilitation for patients with mild to moderate chronic low back pain. Spine (Phila Pa 1976) 38:2190–2195. https://doi.org/10.1097/BRS.0000000000000002 CrossRefGoogle Scholar
- 44.Guigui P, Levassor N, Rillardon L et al (2003) Physiological value of pelvic and spinal parameters of sagital balance: analysis of 250 healthy volunteers. Rev Chir Orthop Reparatrice Appar Mot 89:496–506. RCO-10-2003-89-6-0035-1040-101019-ART3Google Scholar
- 48.National Institutes of Health (1991) Gastrointestinal surgery for severe obesity. In: Consensus statement. National Institutes of Health consensus development conference, pp 1–20Google Scholar