Background. The relationship between underweight and lumbar spine surgery is still unknown. Aim. To evaluate the effect of underweight versus obesity based on surgical outcome of lumbar disc herniation. Material and Method. In this retrospective study, we evaluated 206 patients (112 male and 94 female) with a mean age of years old (ranged 20–72) who have been surgically treated due to the refractory simple primary L4-L5 disc herniation. We followed them up for a mean period of months (ranged 24–57). We used Body Mass Index (BMI), Oswestry Disability Index (ODI), and Visual Analogue Scale (VAS) for categorization, disability, and pain assessment, respectively. We used Wilcoxon and Mann-Whitney tests for statistics. Results. Surgical discectomy in all weight groups was associated with significant improvement in pain and disability, but intergroup comparison showed these improvements in both underweight and obese groups and they were significantly lower than in normal weight group. Excellent and good satisfaction rate was also somewhat lower in both these ends of weight spectrum, but statistically insignificant. Conclusion. Both obesity and underweight may have adverse prognostic influences on the surgical outcome of lumbar disc herniation, although their impact on subjective satisfaction rate seems to be insignificant. 1. Introduction Obesity with its increased stress on the lumbar spine has a known adverse effect on lumbar intervertebral discs. The relationship between obesity and low back pain (LBP) has been repeatedly discussed previously. Numerous authors emphasized the unfavorable effects of obesity on the spinal column including back pain, facet arthrosis, and degenerative disc disease [1–11]. Albeit, it is worth noting that this relationship is not accepted by all authors [12]. Obesity has also been accused of an increased incidence of postoperative spinal complications, but in appropriately indicated patients, it is certainly associate with satisfactory outcomes [13–16]. Therefore, it is nearly proven that obesity has several adverse effects on the lumbar spine but does this mean that underweight has a protective effect on it? Is underweight associated with better lumbar spinal surgical outcomes? There is still little investigation has been performed to evaluate a possible relationship between underweight and the results of lumbar surgeries. In this study we aimed to evaluate the effect of underweight versus obesity on the surgical outcome of the patients with symptomatic lumbar disc herniation who have undergone operative treatment. 2. Materials
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