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Title: Substantial Weight Reduction After Bariatric Surgery Associated With Reduced Pre-Existing Back Pain: Presented at AANS

"Substantial Weight Reduction After Bariatric Surgery Associated With Reduced Pre-Existing Back Pain: Presented at AANS"

By Mary Beth Nierengarten CHICAGO -- May 2, 2008 -- For patients with lower back pain who undergo bariatric surgery, substantial weight loss following surgery results in moderate reductions in back pain, investigators reported here at the 76th Annual Meeting of the American Association of Neurological Surgeons (AANS 2008). Although both obesity and back pain are prevalent conditions, the association between the two is not well studied. The study presented here on April 28, said lead author Paul Khoueir, MD, Assistant Professor, Department of Neurological Surgery, University of Montreal, Montreal, Quebec, Canada, is the first North American study on this subject. In this study, 38 patients with axial low back pain scheduled to undergo bariatric surgery at the University of Southern California, Los Angeles, California, were enrolled in the study over a period of 6 months. The mean patient age was 48 years (range: 20-68 years), the majority were women (n = 30), the mean preoperative weight was 144.5 kg, and mean body mass index (BMI) was 52.3 kg/m[².

Several measurement scales, including the visual analog scale (VAS) to assess axial low back pain, the SF-36 Health Survey to assess quality of life, and Oswestry Disability Index (ODI) to measure lumbar symptoms, were used to compare preoperative and postoperative data.

At 1 year following surgery, the study found significant weight reduction in the entire cohort. Weight decreased by 27.1%, from 144.5 kg preoperatively to 105.59 kg after surgery (P < .0001). BMI decreased by 26.9%, from 52.25 to 38.3 kg/m² (P < .0001).

The study also found a significant decrease in the mean VAS scores for axial low back pain, with decreases from a preoperative score of 5.2 to 2.6 after surgery (P = .006), representing a 44% overall decrease. At 1 year, VAS scores improved in 68.4% of the patients, were stable in 13%, and deteriorated in 18.4%.

Patients also showed a significant decrease in ODI scores -- from 26.75 to 20.35 (P = .05), representing a 24% decrease in physical disability after surgery compared with before surgery.

Although measurements of both physical and mental categories as found on the SF-36 scale significantly improved after surgery, the mental health score increased only by 6%, whereas the physical health score increased by 58%.

The authors concluded that early results (at 1 year) show that substantial weight loss following bariatric surgery is associated with moderate reductions in pre-existing back pain. The investigators emphasised, however, that larger trials with a longer follow-up are needed to further evaluate this association.

[Presentation title: Prospective Assessment of Axial Back Pain Symptoms Before and After Bariatric Weight Reduction Surgery. Abstract 723]

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