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The purpose of this study was to ascertain any difference in clinical improvement or complication rates between obese and nonobese patients following decompression alone compared with decompression plus fusion for lumbar spinal stenosis (LSS).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The Quality Outcomes Database (QOD), formerly known as the National Neurosurgery Quality and Outcomes Database (N<jats:sup>2<\/jats:sup>QOD), was queried for patients who had undergone decompression plus fusion (D+F group) versus decompression alone (D+0 group) for LSS and were stratified by a body mass index (BMI) \u2265 30 kg\/m<jats:sup>2<\/jats:sup> (obese) or &lt; 30 kg\/m<jats:sup>2<\/jats:sup> (nonobese). Demographic, surgical, and health-related quality of life data were compared.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>In the nonobese cohort, 947 patients underwent decompression alone and 319 underwent decompression plus fusion. In the obese cohort, 844 patients had decompression alone and 337 had decompression plus fusion. There were no significant differences in the Oswestry Disability Index score or in leg pain improvement at 12 months when comparing decompression with fusion to decompression without fusion in either obese or nonobese cohorts. However, absolute improvement in back pain was less in the obese group when decompression alone had been performed. Blood loss and operative time were lowest in the nonobese D+0 cohort and were higher in obese patients with or without fusion. Obese patients had a longer hospital stay (4.1 days) than the nonobese patients (3.3 days) when fusion had been performed. In-hospital stay was similar in both obese and nonobese D+0 cohorts. No significant differences were seen in 30-day readmission rates among the 4 cohorts.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Consistent with the prior literature, equivalent clinical outcomes were found among obese and non-obese patients treated for LSS. In addition, no difference in clinical outcomes as related to the extent of the surgical procedure was observed between obese and nonobese patients. Within the D+0 group, the nonobese patients had slightly better back pain scores at 2 years postoperatively. There may be a higher blood product requirement in obese patients following spine surgery, as well as an extended hospital stay, when fusion is performed. While obesity may influence the decision for or against surgery, the data suggest that obesity should not necessarily alter the appropriate procedure for well-selected surgical candidates.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.7.spine16448","type":"journal-article","created":{"date-parts":[[2016,10,14]],"date-time":"2016-10-14T14:02:30Z","timestamp":1476453750000},"page":"158-162","source":"Crossref","is-referenced-by-count":65,"title":["Impact of obesity on complications and outcomes: a comparison of fusion and nonfusion lumbar spine surgery"],"prefix":"10.3171","volume":"26","author":[{"given":"Ikemefuna","family":"Onyekwelu","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Louisville School of Medicine;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Glassman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Louisville School of Medicine;"},{"name":"Norton Leatherman Spine Center, Louisville, Kentucky;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony L.","family":"Asher","sequence":"additional","affiliation":[{"name":"Carolina Neurosurgery & Spine, Charlotte, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen V.","family":"Mummaneni","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah Y.","family":"Carreon","sequence":"additional","affiliation":[{"name":"Norton Leatherman Spine Center, Louisville, Kentucky;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine16448","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"2800","DOI":"10.1007\/s00586-013-2890-6","article-title":"Body mass index and risk of surgical site infection following spine surgery: a meta-analysis","volume":"22","author":"Abdallah DY,","year":"2013","unstructured":"Abdallah DY, Jadaan MM, McCabe JP: Body mass index and risk of surgical site infection following spine surgery: a meta-analysis. 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