Morbid Obesity Complicates Treatment of Spine Trauma
(HealthDay News) – Morbid obesity complicates treatment of spine trauma, including imaging quality, surgical challenges, and postoperative nursing care, according to a case series published online May 21 in the Journal of Neurosurgery: Spine.
To consider the challenges presented in aspects of management of morbidly obese individuals, Hannah E. Rosenfeld, of the University of Adelaide in Australia, and colleagues selected six cases, all involved in high-speed motor vehicle accidents causing multisystem injuries, who were treated surgically for spine trauma during a two-year period at a single trauma center in Australia. All patients in this case series weighed >265 pounds (120kg) and had a body mass index of ≥40kg/m².
The researchers found that morbid obesity may compromise medical and surgical care and may worsen outcomes. Because of these challenges, the time involved in the care of these patients may be extended by many hours. Morbidly obese patients may not fit into scanners and imaging quality may be poorer. The need for alternate patient positioning, difficulty in surgical access and verification of the anatomical level, and availability of longer instruments are issues that may arise in surgical care. Other significant issues for morbidly obese patients include postoperative nursing care, wound healing, and prophylaxis of venous thromboembolism.
"Management pathways and hospital guidelines should be developed to optimize the treatment of morbidly obese patients, but innovative solutions may be required for individual cases," the authors write.