Body Mass Index as a Risk Factor for Recurrence and Frequency of Re-surgery after Lumbar Spine Surgery
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Obesity is linked to degenerative spinal disorders, but its effect on recurrence and re-surgery after lumbar spine surgery remains unclear. Elevated body mass index (BMI) may influence outcomes through biomechanical stress and metabolic inflammation. OBJECTIVE: To evaluate the association between BMI and the risk of recurrence and re-surgery following lumbar discectomy. METHODS: This retrospective cohort study included 286 adult patients (171 males, 115 females; mean age 41.9 ± 11.2 years) who underwent single-level lumbar discectomy for degenerative disc disease at Al-Ahrar Teaching Hospital and Zagazig University Hospitals, Egypt, between January 2015 and October 2025. Patients with multilevel disease, spinal instability, prior lumbar surgery, or incomplete follow-up were excluded. BMI was recorded at surgery and follow-up. Recurrence was defined clinically and radiologically, confirmed by re-surgery. Logistic regression and Kaplan-Meier analysis assessed associations between BMI and recurrence. RESULTS: increase in BMI increased recurrence odds by 38% (OR = 1.38; 95% CI 1.17-1.63; P < 0.001). Kaplan-Meier analysis showed shorter recurrence-free survival in patients with elevated BMI (P < 0.001). Modic changes were the strongest independent risk factor. CONCLUSION: Elevated BMI is significantly associated with increased recurrence and reoperation after lumbar discectomy. Preoperative BMI optimization may reduce the risk of re-surgery and improve postoperative outcomes.
Source: World Neurosurgery
Institution: Zagazig University
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,943
OpenAlex ID: W7125378768