The Journal of Bone and Joint Surgery (American). 2008;90:742-747.
doi:10.2106/JBJS.G.00724
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Weight Loss in Overweight and Obese Patients Following Successful Lumbar Decompression

Ryan M. Garcia, MD1, Patrick J. Messerschmitt, MD1, Christopher G. Furey, MD1, Henry H. Bohlman, MD1 and Ezequiel H. Cassinelli, MD2

1 Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106
2 Peachtree Orthopaedic Clinic, 5505 Peachtree Dunwoody Road, Suite 600, Atlanta, GA 30342. E-mail address: zcassinelli{at}pocatlanta.com
Investigation performed at the Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Background: Neurogenic claudication secondary to lumbar stenosis is often cited by overweight and obese patients as a factor limiting their ability to lose weight. Many patients believe that they will be able to increase their activity and subsequently lose weight following relief of symptoms. The objective of this study was to evaluate weight loss in overweight and obese patients who obtained substantial pain relief after lumbar decompression surgery for spinal stenosis.

Methods: Changes in the body weight and body mass index of overweight and obese patients after lumbar decompression surgery were assessed at a mean of 34.4 months postoperatively. Sixty-three patients (thirty-seven men and twenty-six women with a mean age of 53.4 years) were included in the study. Preoperative and postoperative body weight and body mass indices were calculated, and Zurich Claudication Questionnaire (ZCQ) Symptom Severity and Physical Function scores were obtained.

Results: The ZCQ Symptom Severity and Physical Function scores significantly improved, by a mean of 56.4% and 53.0%, respectively. At the time of follow-up, both the mean body weight and the mean body mass index significantly increased, by 2.48 kg and 0.83 kg/m2, respectively. Overall, 35% of the patients gained ≥5% of their preoperative body weight, 6% of the patients lost ≥5% of their preoperative body weight, and 59% remained within 5% of their preoperative body weight.

Conclusions: The majority of overweight and obese patients maintain or increase their body weight and body mass index following successful lumbar decompression surgery. Substantial relief of symptoms and functional improvements do not appear to help overweight or obese patients to lose weight. This suggests that obesity is an independent disease and not simply a function of symptomatic spinal stenosis, and patients should be counseled regarding these expectations.

Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.


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