Laminectomies and achondroplasia: does body mass index influence surgical outcomes?

Obesity is a widespread and potentially serious health problem in individuals with achondroplasia. In addition to obesity, such individuals commonly experience lumbar spinal stenosis. Although laminectomies have long been the method of choice for thorough lumbar decompression, to the best of our knowledge, the relationship between body mass index (BMI) and surgical outcomes after laminectomy in patients with achondroplasia has not been investigated in a large patient population. Through a retrospective medical record review of the initial laminectomies of all individuals with achondroplasia at our institution for whom adequate records were available, we evaluated the influence of BMI on surgical outcomes after laminectomy via four criteria: (1) change in Rankin score; (2) change in walking distance; (3) intra-operative and post-operative complications; and (4) need for subsequent revision laminectomies. The 49 individuals (mean BMI: 31.5 kg/m(2) at the time of laminectomy) were stratified into the standard BMI categories: normal (<25 kg/m(2)), overweight (25-29.9 kg/m(2)), obese Class I (30-34.9 kg/m(2)), and a combined obese Class II (35-39.9 kg/m(2)) and obese Class III (>40 kg/m(2)). Our analysis indicated that there was no statistical difference between these groups in terms of the four criteria. When the study group was categorized into non-obese (normal weight and overweight) and obese (obese Classes I and II/III) groups, there was also no statistically significant improvement difference in terms the same four criteria. Our data suggest that obesity does not pose additional risks to laminectomy in individuals with achondroplasia.