The Impact of Obesity on the Outcomes of Spinal Fusion Surgery: A Systematic Review.

Objectives: To evaluate the impact of obesity on the outcomes of spinal fusion surgery, an increasingly common procedure for various spinal pathologies. Methods: A thorough search across four databases identified 724 relevant publications. After removing duplicates using Rayyan QCRI and screening for relevance, 391 full-text articles were reviewed, with 7 studies ultimately meeting the criteria for inclusion. Results: We included seven studies with a total of 1454 patients who underwent spinal fusion surgery, and nearly half of them 734 (50.5%) were males. Obesity impacts several outcomes in spinal fusion surgery. While it does not significantly affect operative times or self-reported outcomes, it is associated with longer hospital stays and increased intraoperative blood loss. Elevated BMI is an independent predictor of extended hospitalization and postoperative complications in long-segment fusions. Although obesity generally does not influence pain scores, readmission rates, or reoperation rates, morbidly obese patients experience more perioperative challenges, such as higher costs, longer surgeries, and more frequent complications. Conclusion: Obesity significantly impacts perioperative outcomes in spinal fusion surgery, particularly in terms of blood loss, hospital stay, and postoperative complications. While long-term outcomes such as reoperation and readmission rates are not heavily influenced by BMI, the immediate perioperative period presents notable challenges. Addressing these through preoperative planning, enhanced perioperative management, and postoperative care tailored to obese patients can improve surgical outcomes and recovery. Given the rising prevalence of obesity, these findings are critical for optimizing care for this growing patient population. [ABSTRACT FROM AUTHOR]