A Meta-analysis of the Impact of Bariatric Surgery on Back Pain
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A Meta-analysis of the Impact of Bariatric Surgery on Back Pain Irena Stefanova 1 & Andrew C. Currie 2 & Richard C. Newton 3 & Lorraine Albon 4 & Guy Slater 3 & William Hawkins 3 & Christopher Pring 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background The functional aspects of obesity are increasingly recognised as a significant clinical and public health concern. Whilst there is substantial evidence for the beneficial impact of bariatric surgery on metabolic and cardiovascular disease, there is less understanding of the quantitative effect of bariatric surgery on back pain. The aim of this meta-analysis was to assess the impact of bariatric surgery on back pain in reported studies. Methods Medline, Embase, conference proceedings and reference lists were searched for studies assessing quantitative back pain scores both before and after bariatric surgery. The primary outcome was visual analogue score for back pain pre- and postbariatric surgery. Secondary outcomes were change in BMI, SF-36 quality of life scores and Oswestry Disability Index (ODI) scores. Weighted mean differences (MD) were calculated for continuous outcomes. Results Seven studies were included in the analysis of 246 patients undergoing bariatric surgery. Mean study follow-up was between 3 and 24 months. There was a statistically significant reduction in visual analogue score for back pain following bariatric surgery (MD − 3.01; 95% CI − 4.19 to − 1.89; p < 0.001). Bariatric surgery also resulted in statistically significant improvements in BMI, SF-36 score and ODI score. Conclusions Bariatric surgery produces significant and quantifiable reductions in back pain. This may be commuted through reductions in axial load or improved quality of life, but further studies will improve understanding and aid preoperative counselling. Keywords Back pain . Bariatric surgery . Visual analogue score . Quality of life
Introduction Global levels of obesity are increasing and constitute a major health concern due to obesity-related disease [1, 2]. The main health consequences related to obesity include
Irena Stefanova and Andrew C Currie are considered joint first authors. * Irena Stefanova [email protected] 1
Department of General Surgery, Royal Surrey County Hospital, Guildford, UK
2
Regional Oesophagogastric Unit, Royal Surrey County Hospital, Guildford, UK
3
Department of Bariatric Surgery, St Richard’s Hospital, Chichester, UK
4
Department of Bariatric Surgery and Diabetes, St Richard’s Hospital, Chichester, UK
type 2 diabetes, cardiovascular disease, musculoskeletal disorders such as osteoarthritis and low back pain, and certain cancers. Metabolic surgery has been shown in multiple randomised trials and meta-analyses to be effective at improving obesity-related comorbidities and improving quality of life [3]. Whilst the focus on comorbidity management for patients with obesity has tended to focus on type 2 diabetes and cardiovascular disease, there is an increasing focus on quality of life and phy
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