Minimally invasive lumbar discectomy in obese patients

OBJECTIVE:To assess patient outcomes and complication rates after minimally invasive lumbar microdiscectomy in an obese patient population. METHODS: A retrospective clinical review of 32 patients with a body mass index of 30 kg/m(2) or greater undergoing lumbar minimally invasive discectomy was performed. The initial chart review was followed,by phone interview if all information could not be obtained from chart review. Demographic and pertinent pre-, peri-, and postoperative data were obtained. RESULTS: Favorable clinical outcomes were obtained in all patients except one, indicating that they would undergo operative intervention again. Most patients reported minimal or no leg or back pain. Twenty-five of the patients did not require any chronic m analgesia. The overall complication rate was 12.5%. Two patients had recurrent disc herniations requiring reoperation and one patient required fusion for a pars defect and subsequent subluxation. CONCLUSION: Lumbar minimally invasive discectomy is our preferred surgical technique for symptomatic disc herniations in this patient population. Decreased incision length and a trend toward reduced infectious complications are the primary reasons. We feel that, given the comorbidities often found in this patient population, a minimally invasive technique will supplant open approaches in the near future.