Morbid Obesity Increases Length of Surgery in Elective Anterior Cervical Discectomy and Fusion Procedures but Not Readmission or Reoperation Rates: A Cohort Study

-BACKGROUND: As the obesity epidemic grows, -umber of morbidly obese patients undergoing anterior cervical discectomy and fusion (ACDF) continues to crease. Despite the association of obesity with perioper-ative complications in anterior cervical surgery, the impact of morbid obesity on ACDF complications remains contro-versial, and studies examining morbidly obese cohorts limited. -METHODS: A single-institution, retrospective analysis patients undergoing ACDF from September 2010 to February 2022 was performed. Demographic, intraoperative, and postoperative data were collected via review of the elec-tronic medical record. Patients were categorized as non obese (body mass index [BMI] <30), obese (BMI 30-39.9), or morbidly obese (BMI double dagger 40). Associations of BMI class with discharge disposition, length of surgery, and length stay were assessed using multivariable logistic regression, multivariable linear regression, and negative binomial regression, respectively. -RESULTS: The study included 670 patients undergoing single-level or multilevel ACDF: 413 (61.6%) nonobese, (33.7%) obese, and 31 (4.6%) morbidly obese patients. BMI class was associated with prior history of deep venous thrombosis (P < 0.01), pulmonary thromboembolism (P < 0.05), and diabetes mellitus (P < 0.001). In bivariate analysis, there was no significant association between BMI class and reoperation or readmission rates at 30, 60, or 365 days postoperatively. In multivariable analysis, greater BMI class was associated with increased length of surgery (P [ 0.03), but not length of stay or discharge disposition.- CONCLUSIONS: For patients undergoing ACDF, greater BMI class was associated with increased length of sur- gery, but not reoperation rate, readmission rate, length of stay, or discharge disposition.