ArticleBrain & spine2026
Postoperative pain improvement in obese patients is not associated with long-term weight reduction after lumbar fusion surgery.
Article in Brain & spine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Obese patients are often advised to lose weight before spinal surgery to improve postoperative outcomes. However, pain-related functional limitations make preoperative weight reduction unfeasible. In this context, it would be expected that postoperative pain relief facilitates subsequent weight reduction. Thus, the objective of this study was to examine whether a positive clinical response to mono- or bisegmental lumbar fusion for degenerative indications is associated with body-weight change during long-term follow-up. Methods: In this retrospective study, 53 obese patients (BMI ≥30) who underwent spinal fusion surgery between 2020 and 2022 were analyzed. A positive response was defined as a reduction of ≥2 points on the visual analog scale (VAS) for back pain. Patients were divided into responders (R; n = 33) and non-responders (NR; n = 20). Results: Baseline characteristics showed no significant difference. Mean follow-up was 3.5 years. Overall, BMI decreased from 34 ± 4 to 33 ± 5 (p = 0.002), corresponding to a mean weight reduction from 100 ± 18 kg to 97 ± 21 kg (p = 0.003). In subgroup analyses, a significant BMI decrease of 7% was observed in the NR group (p = 0.004), whereas no statistically significant BMI change was observed in the R group. Conclusion: Postoperative pain relief did not appear to be associated with long-term weight loss in this cohort. These findings suggest that key factors other than pain relief may influence physical activity and weight change in obese patients following spinal fusion.
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