Poster Presentation Sydney Spinal Symposium 2022

Obesity Back pain Evaluation Laparoscopic bariatric surgery and Imaging with X-ray and MRI study (OBELIX): A prospective observational cohort study (#123)

Froukje Koremans 1 2 3 , Ken Loi 2 , Mark Madgy 2 , John Jorgensen 2 , Vytauras Kuzinkovas 2 , David Simar 4 , Ashish D Diwan 1 3
  1. Spine Service, St George Hospital, Kogarah, NSW, Australia
  2. St George Obesity & General surgery Clinic, St George Hospital, Kogarah, NSW, Australia
  3. Spine labs, Bondi Beach, NSW, Australia
  4. University of New South Wales, Kensington, NSW, Australia

Background Obesity is a growing problem worldwide and is associated with an increased risk for multiple diseases, including musculoskeletal diseases and back pain. Several systematic reviews reported encouraging data and quantifiable reductions in back pain score outcomes after bariatric surgery produces. However,  a lack of information on the association in back pain outcomes, mechanical properties and weight loss remains. We aim to explore the effect obesity and rapid weight loss by bariatric surgery has on the spine and back pain in obese patients and address the association between changes in body mass index (BMI), pain score, spinal imaging and biospecimen.

Method An international prospective controlled cohort using (1) obese patients undergoing bariatric surgery at different clinics located at Sydney and the Netherlands (=Group O) and (2) non-surgical obese patients (=Group N), with a follow up for 2 years. During follow-up we aim to collect

Back pain questionnaires; at enrolment, after 3 months, 6 months, 1  year and 2 years.

  1. Blood; at enrolment and 6 months.
  2. Imaging (standing X-ray and MRI); at enrolment and 1 year.
  3. Waist circumference measurements (as reference to BMI); at enrolment and 6 months.
  4. Activity tracker; at enrolment and a week before the second waist circumference measurement.

Research participants  We intent to include morbid obese adults, age between 18 and 60 years, with a BMI ≥ 40 or ≥ 35 with comorbidities, eligible for bariatric surgery. Excluded are participants who are not eligible for bariatric surgery, had prior spinal surgery, had antibiotics within one month and pregnant or breastfeeding females.

Conclusion The relationship between weight loss and reduction in back pain is complex but remains scientifically unclear. To further understand how and why bariatric surgery could reduce the back pain problems of obese patients, we aim to evaluate the potential changes in biospecimens/imaging/activity after surgery and if these are related to backpain.