Spine
November 3, 2025 · via Europe PMC
Body Mass Index and Surgical Outcomes in Degenerative Cervical Myelopathy: Findings From a Prospective Multicenter Cohort of 935 Patients.
Okubo T, Nagoshi N, Yamane J, +12 more, Watanabe K.
AI summary — for doctors, generated from the abstract only
Higher BMI in degenerative cervical myelopathy was linked to greater operative demands, but neurological recovery and patient-reported outcomes were similar across BMI groups.
What was studied
A prospective multicenter cohort of 935 patients undergoing surgery for degenerative cervical myelopathy at 10 Japanese spine centers, stratified by BMI.
Key findings
- Obese patients were younger (mean 60.2 years)
- Higher BMI was associated with greater operative demands and higher OPLL prevalence
- Higher BMI was associated with persistent postoperative alignment and motion deficits
- Neurological recovery and PROs were comparable across BMI categories
Clinical relevance
Suggests BMI alone may not need to deter surgery for DCM when indicated; data come from a single country's high-volume centers.
Who should care
Limitations
Conducted only in Japan, where obesity distribution may differ from other populations; detailed statistics truncated in the abstract.
Patients with higher BMI appear to benefit from myelopathy surgery as much as others.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Study design
Prospective multicenter cohort study.
Objectives
To clarify the relationship between body mass index (BMI) and surgical outcomes in degenerative cervical myelopathy (DCM).
Summary of background data
Obesity is a growing global health concern and has been implicated in DCM. However, evidence on whether BMI affects postoperative neurological and patient-reported outcomes remains inconsistent, with limited prospective multicenter data.
Methods
We prospectively analyzed 935 patients with DCM who underwent surgery at 10 high-volume spine centers in Japan. Patients were categorized as underweight (<18.5), normal weight (18.5-24.9), overweight (25.0-29.9), or obesity (≥30.0) per World Health Organization criteria. Demographics, comorbidities, radiographic parameters, operative variables, and outcomes-Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) pain scores, Short Form-36 physical (PCS) and mental (MCS) component scores, and Neuropathic Pain Symptom Inventory (NPSI)-were compared across BMI groups over a two-year follow-up.
Results
Obese patients were younger (mean: 60.2 y, P <0.001) and had a higher prevalence of OPLL (47.7%, P <0.001). They required longer operative time (128.3 min) and greater blood loss (91.2 mL) (both P <0.001) but did not have higher perioperative complication rates. Obesity was associated with smaller C2 to 7 lordosis and reduced cervical range of motion preoperatively and at two years (both P <0.05). Underweight patients had the largest mean MCS improvement (+6.0), but differences among BMI groups were not statistically significant ( P =0.117). Across all groups, JOA score improvement, recovery rate, PCS change, pain reduction, and NPSI improvement were comparable.
Conclusions
Higher BMI in DCM was associated with greater operative demands, higher OPLL prevalence, and persistent postoperative alignment and motion deficits. However, neurological recovery and patient-reported outcomes were comparable across BMI categories. In patients with surgical indications based on symptoms and imaging findings, surgery can be performed appropriately regardless of BMI, with favorable outcomes achievable through thorough preoperative assessment and strategic surgical planning.
Level of evidence
Level II.
DOI
10.1097/brs.0000000000005554
PMID
41178280
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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