Does the number of levels affect lumbar fusion outcome?
When using strict patient selection criteria that include independent determination of pain generators via pressure-controlled diskography and completion of a preoperative conditioning program for improving general health status, the number of levels in reconstructive lumbar surgery may not significantly impact overall clinical outcome.
The HOMA-IR, which is strictly related to visceral fat and is an index of metabolic impairment, and not BMI, which reflects of global adiposity, can be used to identify early vascular impairment in patients with morbid obesity.