The Effect of Obesity on Clinical Outcomes After Minimally Invasive Surgery of the Spine: A Systematic Review and Meta-Analysis.

BACKGROUND: Obesity is associated with increasing morbidity and mortality in many prevalent diseases, especially lumbar degenerative disease. The relationship between minimally invasive surgery (MIS) of the spine and perioperative adverse events in obese patients with lumbar degenerative disease has not been well evaluated. METHODS: We conducted a systematic review and meta-analysis to identify relevant studies involving obese patients with spine MIS in electronic databases up to June 2017, including Web of Science, Embase, PubMed, the Cochrane Controlled Trials Register, and the Cochrane Library. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system, and Cochrane Handbook were applied to assess the quality of the results published in all included studies. RESULTS: No significant difference was found in postoperative complications between obese and nonobese patients, according to the Oswestry Disability Index, and visual analog scale. However, there were significant differences between the 2 groups in surgery time, blood loss, and length of hospital stay. CONCLUSIONS: There does not seem to be an increased risk of developing perioperative complications in obese patients undergoing spine MIS. Spine MIS was a safe and effective technique for obese patients. However, according to our pooled data, longer surgery time was observed in obese patients.