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Published in: Neurosurgical Review 5/2020

Open Access 01-10-2020 | Obesity | Original Article

The impact of obesity and smoking on young individuals suffering from lumbar disc herniation: a retrospective analysis of 97 cases

Authors: Sara Lener, Christoph Wipplinger, Sebastian Hartmann, Claudius Thomé, Anja Tschugg

Published in: Neurosurgical Review | Issue 5/2020

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Abstract

The negative impact on spinal diseases may apply not only to obesity but also to smoking. To investigate the influence of obesity and smoking on the development and recovery of lumbar disc herniation in young adults. Retrospective analysis of 97 patients who presented with lumbar disc herniation at the authors’ department between 2010 and 2017. Data were collected using the patients’ digital health records including demographics, clinical and neurological characteristics, treatment details, and outcomes. Ninety-seven patients between 17 and 25 years were included in this retrospective analysis. Patients were categorized into two groups according to their body mass index: obese (O, ≥ 30 kg/m2) and non-obese (NO, < 30 kg/m2). The proportion of obese patients in our cohort vs. in the overall population differed significantly (19.4% vs. 3.8–7.1%, RR 3.17; p < 0.01). Group NO showed a trend toward faster recovery of motor deficits (p = 0.067) and pain (p = 0.074). Also, the proportion of regular smokers differed significantly from the numbers of known smokers of the same age (62.4% vs. 30.2%, RR 2.0; p = 0.01). Obesity plus smoking showed a significantly negative impact on motor deficits postoperatively (p = 0.015) and at discharge (p = 0.025), as well as on pain values (p = 0.037) and on analgesic consumption (p = 0.034) at 6 weeks follow-up. The negative impact of obesity and smoking on the occurrence of lumbar disc herniation could be demonstrated for individuals aged 25 or younger. Furthermore, a trend to earlier recovery of motor deficits and significantly lower pain scales for non-obese and non-smoking patients could be shown.
Literature
1.
go back to reference Lobstein T, Baur L, Uauy R (2004) Obesity in children and young people: a crisis in public health. Obesity Rev 5(Suppl 1):4–85CrossRef Lobstein T, Baur L, Uauy R (2004) Obesity in children and young people: a crisis in public health. Obesity Rev 5(Suppl 1):4–85CrossRef
4.
go back to reference Sheng B, Feng C, Zhang D, Spitler H, Shi L (2017) Associations between obesity and spinal diseases: a medical expenditure panel study analysis. Int J Environ Res Public Health 14(2) Sheng B, Feng C, Zhang D, Spitler H, Shi L (2017) Associations between obesity and spinal diseases: a medical expenditure panel study analysis. Int J Environ Res Public Health 14(2)
5.
go back to reference Fransen M, Woodward M, Norton R, Coggan C, Dawe M, Sheridan N (2002) Risk factors associated with the transition from acute to chronic occupational back pain. Spine (Phila Pa 1976) 27(1):92–98CrossRef Fransen M, Woodward M, Norton R, Coggan C, Dawe M, Sheridan N (2002) Risk factors associated with the transition from acute to chronic occupational back pain. Spine (Phila Pa 1976) 27(1):92–98CrossRef
6.
go back to reference Samartzis D, Karppinen J, Mok F, Fong DY, Luk KD, Cheung KM (2011) A population-based study of juvenile disc degeneration and its association with overweight and obesity, low back pain, and diminished functional status. J Bone Joint Surg Am 93(7):662–670PubMedCrossRef Samartzis D, Karppinen J, Mok F, Fong DY, Luk KD, Cheung KM (2011) A population-based study of juvenile disc degeneration and its association with overweight and obesity, low back pain, and diminished functional status. J Bone Joint Surg Am 93(7):662–670PubMedCrossRef
7.
go back to reference Meredith DS, Huang RC, Nguyen J, Lyman S (2010 Jul) Obesity increases the risk of recurrent herniated nucleus pulposus after lumbar microdiscectomy. Spine J 10(7):575–580PubMedCrossRef Meredith DS, Huang RC, Nguyen J, Lyman S (2010 Jul) Obesity increases the risk of recurrent herniated nucleus pulposus after lumbar microdiscectomy. Spine J 10(7):575–580PubMedCrossRef
8.
go back to reference Patel N, Bagan B, Vadera S, Maltenfort MG, Deutsch H, Vaccaro AR, Harrop J, Sharan A, Ratliff JK (2007) Obesity and spine surgery: relation to perioperative complications. J Neurosurg Spine. 6(4):291–297PubMedCrossRef Patel N, Bagan B, Vadera S, Maltenfort MG, Deutsch H, Vaccaro AR, Harrop J, Sharan A, Ratliff JK (2007) Obesity and spine surgery: relation to perioperative complications. J Neurosurg Spine. 6(4):291–297PubMedCrossRef
9.
go back to reference Rihn JA, Kurd M, Hilibrand AS, Lurie J, Zhao W, Albert T, Weinstein J (2013) The influence of obesity on the outcome of treatment of lumbar disc herniation: analysis of the Spine Patient Outcomes Research Trial (SPORT). J Bone Joint Surg Am 95(1):1–8PubMedPubMedCentralCrossRef Rihn JA, Kurd M, Hilibrand AS, Lurie J, Zhao W, Albert T, Weinstein J (2013) The influence of obesity on the outcome of treatment of lumbar disc herniation: analysis of the Spine Patient Outcomes Research Trial (SPORT). J Bone Joint Surg Am 95(1):1–8PubMedPubMedCentralCrossRef
10.
go back to reference Strömqvist F, Strömqvist B, Jönsson B, Karlsson MK (2016) The outcome of lumbar disc herniation surgery is worse in old adults than in young adults. Acta Orthop 87(5):516–521PubMedPubMedCentralCrossRef Strömqvist F, Strömqvist B, Jönsson B, Karlsson MK (2016) The outcome of lumbar disc herniation surgery is worse in old adults than in young adults. Acta Orthop 87(5):516–521PubMedPubMedCentralCrossRef
11.
go back to reference Lagerbäck T, Elkan P, Möller H, Grauers A, Diarbakerli E, Gerdhem P (2015) An observational study on the outcome after surgery for lumbar disc herniation in adolescents compared with adults based on the Swedish Spine Register. Spine J 15(6):1241–1247PubMedCrossRef Lagerbäck T, Elkan P, Möller H, Grauers A, Diarbakerli E, Gerdhem P (2015) An observational study on the outcome after surgery for lumbar disc herniation in adolescents compared with adults based on the Swedish Spine Register. Spine J 15(6):1241–1247PubMedCrossRef
12.
go back to reference Tschugg A, Löscher WN, Lener S, Wildauer M, Hartmann S, Neururer S, Thomé C (2017) Gender differences after lumbar sequestrectomy: a prospective clinical trial using quantitative sensory testing. Eur Spine J 26(3):857–864PubMedCrossRef Tschugg A, Löscher WN, Lener S, Wildauer M, Hartmann S, Neururer S, Thomé C (2017) Gender differences after lumbar sequestrectomy: a prospective clinical trial using quantitative sensory testing. Eur Spine J 26(3):857–864PubMedCrossRef
13.
go back to reference Tschugg A, Lener S, Hartmann S, Wildauer M, Löscher WN, Neururer S, Thomé C (2017, Jan 13) Preoperative sport improves the outcome of lumbar disc surgery: a prospective monocentric cohort study. Neurosurg Rev Tschugg A, Lener S, Hartmann S, Wildauer M, Löscher WN, Neururer S, Thomé C (2017, Jan 13) Preoperative sport improves the outcome of lumbar disc surgery: a prospective monocentric cohort study. Neurosurg Rev
15.
go back to reference Huang W, Qian Y, Zheng K, Yu L, Yu X (2016 Jan) Is smoking a risk factor for lumbar disc herniation? Eur Spine J 25(1):168–176PubMedCrossRef Huang W, Qian Y, Zheng K, Yu L, Yu X (2016 Jan) Is smoking a risk factor for lumbar disc herniation? Eur Spine J 25(1):168–176PubMedCrossRef
16.
go back to reference Mattila VM, Saarni L, Parkkari J, Koivusilta L, Rimpelä A (2008) Early risk factors for lumbar discectomy: an 11-year follow-up of 57,408 adolescents. Eur Spine J 17(10):1317–1323PubMedPubMedCentralCrossRef Mattila VM, Saarni L, Parkkari J, Koivusilta L, Rimpelä A (2008) Early risk factors for lumbar discectomy: an 11-year follow-up of 57,408 adolescents. Eur Spine J 17(10):1317–1323PubMedPubMedCentralCrossRef
17.
go back to reference Schumann B, Bolm-Audorff U, Bergmann A, Ellegast R, Elsner G, Grifka J, Haerting J, Jäger M, Michaelis M, Seidler A (2010) Lifestyle factors and lumbar disc disease: results of a German multi-center case-control study (EPILIFT). Arthritis Res Ther 12(5):R193PubMedPubMedCentralCrossRef Schumann B, Bolm-Audorff U, Bergmann A, Ellegast R, Elsner G, Grifka J, Haerting J, Jäger M, Michaelis M, Seidler A (2010) Lifestyle factors and lumbar disc disease: results of a German multi-center case-control study (EPILIFT). Arthritis Res Ther 12(5):R193PubMedPubMedCentralCrossRef
18.
go back to reference Diener HC, Weimar C, Berlit P et al (2012) Leitlinien für Diagnostik und Therapie in der Neurologie; Georg Thieme Verlag, 5th edn. Stuttgart, New York, pp 908–920 Diener HC, Weimar C, Berlit P et al (2012) Leitlinien für Diagnostik und Therapie in der Neurologie; Georg Thieme Verlag, 5th edn. Stuttgart, New York, pp 908–920
19.
go back to reference Vanni D, Galzio R, Kazakova A, Guelfi M, Pantalone A, Salini V, Magliani V (2015) Technical note: microdiscectomy and translaminar approach. J Spine Surg 1(1):44–49 ReviewPubMedPubMedCentral Vanni D, Galzio R, Kazakova A, Guelfi M, Pantalone A, Salini V, Magliani V (2015) Technical note: microdiscectomy and translaminar approach. J Spine Surg 1(1):44–49 ReviewPubMedPubMedCentral
20.
go back to reference Thomé C, Barth M, Scharf J, Schmiedek P (2005 Mar) Outcome after lumbar sequestrectomy compared with microdiscectomy: a prospective randomized study. J Neurosurg Spine 2(3):271–278PubMedCrossRef Thomé C, Barth M, Scharf J, Schmiedek P (2005 Mar) Outcome after lumbar sequestrectomy compared with microdiscectomy: a prospective randomized study. J Neurosurg Spine 2(3):271–278PubMedCrossRef
21.
go back to reference Kalichman L, Guermazi A, Li L, Hunter DJ (2009) Association between age, sex, BMI and CT-evaluated spinal degeneration features. J Back Musculoskelet Rehabil 22(4):189–195PubMedCrossRef Kalichman L, Guermazi A, Li L, Hunter DJ (2009) Association between age, sex, BMI and CT-evaluated spinal degeneration features. J Back Musculoskelet Rehabil 22(4):189–195PubMedCrossRef
22.
go back to reference Böstman OM (1994 Oct) Prevalence of obesity among patients admitted for elective orthopaedic surgery. Int J Obes Relat Metab Disord 18(10):709–713PubMed Böstman OM (1994 Oct) Prevalence of obesity among patients admitted for elective orthopaedic surgery. Int J Obes Relat Metab Disord 18(10):709–713PubMed
23.
go back to reference Järvimäki V, Kautiainen H, Haanpää M, Alahuhta S, Vakkala M (2016 Jan) Obesity has an impact on outcome in lumbar disc surgery. Scand J Pain 10:85–89PubMedCrossRef Järvimäki V, Kautiainen H, Haanpää M, Alahuhta S, Vakkala M (2016 Jan) Obesity has an impact on outcome in lumbar disc surgery. Scand J Pain 10:85–89PubMedCrossRef
24.
go back to reference Lloret-Linares C, Lopes A, Declèves X, Serrie A, Mouly S, Bergmann JF, Perrot S (2013 Sep) Challenges in the optimisation of post-operative pain management with opioids in obese patients: a literature review. Obes Surg 23(9):1458–1475PubMedCrossRef Lloret-Linares C, Lopes A, Declèves X, Serrie A, Mouly S, Bergmann JF, Perrot S (2013 Sep) Challenges in the optimisation of post-operative pain management with opioids in obese patients: a literature review. Obes Surg 23(9):1458–1475PubMedCrossRef
25.
go back to reference Brill MJ, Diepstraten J, van Rongen A, van Kralingen S, van den Anker JN, Knibbe CA (2012 May 1) Impact of obesity on drug metabolism and elimination in adults and children. Clin Pharmacokinet 51(5):277–304PubMedCrossRef Brill MJ, Diepstraten J, van Rongen A, van Kralingen S, van den Anker JN, Knibbe CA (2012 May 1) Impact of obesity on drug metabolism and elimination in adults and children. Clin Pharmacokinet 51(5):277–304PubMedCrossRef
26.
go back to reference Petr O, Glodny B, Brawanski K, Kerschbaumer J, Freyschlag C, Pinggera D, Rehwald R, Hartmann S, Ortler M, Thomé C (2017 Jun 27) Immediate versus delayed surgical treatment of lumbar disc herniation for acute motor deficits: the impact of surgical timing on functional outcome. Spine (Phila Pa 1976) Petr O, Glodny B, Brawanski K, Kerschbaumer J, Freyschlag C, Pinggera D, Rehwald R, Hartmann S, Ortler M, Thomé C (2017 Jun 27) Immediate versus delayed surgical treatment of lumbar disc herniation for acute motor deficits: the impact of surgical timing on functional outcome. Spine (Phila Pa 1976)
27.
go back to reference Postacchini F, Giannicola G, Cinotti G (2002) Recovery of motor deficits after microdiscectomy for lumbar disc herniation. J Bone Joint Surg Br 84(7):1040–1045PubMedCrossRef Postacchini F, Giannicola G, Cinotti G (2002) Recovery of motor deficits after microdiscectomy for lumbar disc herniation. J Bone Joint Surg Br 84(7):1040–1045PubMedCrossRef
28.
go back to reference Peul WC, van Houwelingen HC, van den Hout WB, Brand R, Eekhof JA, Tans JT et al (2007) Leiden-The Hague Spine Intervention Prognostic Study Group. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med 356(22):2245–2256PubMedCrossRef Peul WC, van Houwelingen HC, van den Hout WB, Brand R, Eekhof JA, Tans JT et al (2007) Leiden-The Hague Spine Intervention Prognostic Study Group. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med 356(22):2245–2256PubMedCrossRef
29.
go back to reference Kerr D, Zhao W, Lurie JD (2015) What are long-term predictors of outcomes for lumbar disc herniation? A randomized and observational study. Clin Orthop Relat Res 473(6):1920–1930PubMedCrossRef Kerr D, Zhao W, Lurie JD (2015) What are long-term predictors of outcomes for lumbar disc herniation? A randomized and observational study. Clin Orthop Relat Res 473(6):1920–1930PubMedCrossRef
30.
go back to reference Wang Y, Huang F (2015) N-3 polyunsaturated fatty acids and inflammation in obesity: local effect and systemic benefit. Biomed Res Int 2015:581469PubMedPubMedCentral Wang Y, Huang F (2015) N-3 polyunsaturated fatty acids and inflammation in obesity: local effect and systemic benefit. Biomed Res Int 2015:581469PubMedPubMedCentral
31.
go back to reference Yanbaeva DG, Dentener MA, Creutzberg EC, Wesseling G, Wouters EF (2007) Systemic effects of smoking. Chest. 131(5):1557–1566 ReviewPubMedCrossRef Yanbaeva DG, Dentener MA, Creutzberg EC, Wesseling G, Wouters EF (2007) Systemic effects of smoking. Chest. 131(5):1557–1566 ReviewPubMedCrossRef
33.
go back to reference Mern DS, Beierfuβ A, Fontana J, Thomé C, Hegewald AA (2014) Imbalanced protein expression patterns of anabolic, catabolic, anti-catabolic and inflammatory cytokines in degenerative cervical disc cells: new indications for gene therapeutic treatments of cervical disc diseases. PLoS One 9(5):e96870PubMedPubMedCentralCrossRef Mern DS, Beierfuβ A, Fontana J, Thomé C, Hegewald AA (2014) Imbalanced protein expression patterns of anabolic, catabolic, anti-catabolic and inflammatory cytokines in degenerative cervical disc cells: new indications for gene therapeutic treatments of cervical disc diseases. PLoS One 9(5):e96870PubMedPubMedCentralCrossRef
34.
go back to reference Nadeau S, Filali M, Zhang J, Kerr BJ, Rivest S, Soulet D, Iwakura Y, de Rivero Vaccari JP, Keane RW, Lacroix S (2011) Functional recovery after peripheral nerve injury is dependent on the pro-inflammatory cytokines IL-1β and TNF: implications for neuropathic pain. J Neurosci 31(35):12533–12542PubMedPubMedCentralCrossRef Nadeau S, Filali M, Zhang J, Kerr BJ, Rivest S, Soulet D, Iwakura Y, de Rivero Vaccari JP, Keane RW, Lacroix S (2011) Functional recovery after peripheral nerve injury is dependent on the pro-inflammatory cytokines IL-1β and TNF: implications for neuropathic pain. J Neurosci 31(35):12533–12542PubMedPubMedCentralCrossRef
35.
go back to reference Risbud MV, Shapiro IM (2014 Jan) Role of cytokines in intervertebral disc degeneration: pain and disc content. Nat Rev Rheumatol 10(1):44–56PubMedCrossRef Risbud MV, Shapiro IM (2014 Jan) Role of cytokines in intervertebral disc degeneration: pain and disc content. Nat Rev Rheumatol 10(1):44–56PubMedCrossRef
Metadata
Title
The impact of obesity and smoking on young individuals suffering from lumbar disc herniation: a retrospective analysis of 97 cases
Authors
Sara Lener
Christoph Wipplinger
Sebastian Hartmann
Claudius Thomé
Anja Tschugg
Publication date
01-10-2020
Publisher
Springer Berlin Heidelberg
Published in
Neurosurgical Review / Issue 5/2020
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI
https://doi.org/10.1007/s10143-019-01151-y

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