RedWine
05-01-2008, 03:23 AM
Substantial weight loss following bariatric surgery results in moderate reductions in pre-existing back pain, U.S. researchers say.
Researchers at the University of Southern California analyzed the outcomes of 38 bariatric surgery patients with low back pain over a period of six months.
Dr. Paul Khoueir, Mary Helen Black, Dr. Peter F. Crookes, Dr. Namir Katkhouda, Dr. Howard S. Kaufman and Dr. Michael Y. Wang analyzed preoperative and postoperative data including: age, weight, body mass index, back pain intensity, quality of life questionnaires and disability scores to assess differences in subject characteristics and outcomes.
The pain scale decreased by 44 percent, while the physical health component increased by 58 percent.
"This effect does not appear to be the result of the overall improvement associated with the patient's well being," Khoueir said in a statement. "While this initial research is promising, larger long-term trials are needed to prove the efficacy of this treatment."
The findings were presented by Khoueir at the 76th annual meeting of the American Association of Neurological Surgeons in Chicago.
Substantial weight loss from bariatric surgery may relieve back pain, reduce disability, and improve quality of life, researchers reported here.
A year after weight-loss surgery, low back pain intensity decreased 44% and quality of life increased up to 58%, reported Paul Khoueir, M.D., of the University of Southern California, now at the University of Montreal, and colleagues at the American Association of Neurological Surgeons meeting.
Disability related to low back pain also showed a 24% decrease in the small prospective study.
With this weight loss came a 44% reduction in back pain intensity measured on the visual analog scale (2.9 after surgery versus 5.2 before, P=0.006). Pain scores improved by one year for the majority of patients (68.4%) whereas 13% had stable pain scores and the rest got worse.
Patients also had a 24% improvement in physical disability scores measured on the Oswestry Disability Index (20.35 after surgery versus 26.75 before, P=0.05).
Quality of life improved in two domains as well by the one-year postoperative follow-up visit.
Quality of life related to physical health measured with the Short Form (SF-36) Health Survey increased 58% (P<0.0001) while all the components improved significantly as well, including those for bodily pain and general health.
The SF-36 mental health subscale scores rose 6% (P=0.03), but the only significantly improved component was vitality.
The improvements were likely because of the weight loss associated with bariatric surgery rather than the surgery itself, Dr. Khoueir said. His group found a direct association between weight loss and pain intensity. Patients who lost more weight had greater improvements in pain scores than those who lost less weight.
Dr. Khoueir noted that the study was limited by the small number of patients, lack of pre- and postoperative MRI, and by inclusion of only morbidly obese patients.
"We still need larger and much longer studies to definitively associate weight loss with improved low back pain and to ascertain the mechanism by which these musculoskeletal effects occur," the researchers concluded.
Researchers at the University of Southern California analyzed the outcomes of 38 bariatric surgery patients with low back pain over a period of six months.
Dr. Paul Khoueir, Mary Helen Black, Dr. Peter F. Crookes, Dr. Namir Katkhouda, Dr. Howard S. Kaufman and Dr. Michael Y. Wang analyzed preoperative and postoperative data including: age, weight, body mass index, back pain intensity, quality of life questionnaires and disability scores to assess differences in subject characteristics and outcomes.
The pain scale decreased by 44 percent, while the physical health component increased by 58 percent.
"This effect does not appear to be the result of the overall improvement associated with the patient's well being," Khoueir said in a statement. "While this initial research is promising, larger long-term trials are needed to prove the efficacy of this treatment."
The findings were presented by Khoueir at the 76th annual meeting of the American Association of Neurological Surgeons in Chicago.
Substantial weight loss from bariatric surgery may relieve back pain, reduce disability, and improve quality of life, researchers reported here.
A year after weight-loss surgery, low back pain intensity decreased 44% and quality of life increased up to 58%, reported Paul Khoueir, M.D., of the University of Southern California, now at the University of Montreal, and colleagues at the American Association of Neurological Surgeons meeting.
Disability related to low back pain also showed a 24% decrease in the small prospective study.
With this weight loss came a 44% reduction in back pain intensity measured on the visual analog scale (2.9 after surgery versus 5.2 before, P=0.006). Pain scores improved by one year for the majority of patients (68.4%) whereas 13% had stable pain scores and the rest got worse.
Patients also had a 24% improvement in physical disability scores measured on the Oswestry Disability Index (20.35 after surgery versus 26.75 before, P=0.05).
Quality of life improved in two domains as well by the one-year postoperative follow-up visit.
Quality of life related to physical health measured with the Short Form (SF-36) Health Survey increased 58% (P<0.0001) while all the components improved significantly as well, including those for bodily pain and general health.
The SF-36 mental health subscale scores rose 6% (P=0.03), but the only significantly improved component was vitality.
The improvements were likely because of the weight loss associated with bariatric surgery rather than the surgery itself, Dr. Khoueir said. His group found a direct association between weight loss and pain intensity. Patients who lost more weight had greater improvements in pain scores than those who lost less weight.
Dr. Khoueir noted that the study was limited by the small number of patients, lack of pre- and postoperative MRI, and by inclusion of only morbidly obese patients.
"We still need larger and much longer studies to definitively associate weight loss with improved low back pain and to ascertain the mechanism by which these musculoskeletal effects occur," the researchers concluded.