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Spinal Fusion Surgery in Severe Obesity


Lower back pain is not an uncommon finding in obese and very obese individuals. One surgical treatment option is to create a fusion between two or more vertebrae in an attempt to reduce pain by stopping the motion at the painful vertebral segment(s).

In a paper just published in SPINE, Rahul Vaidya and colleagues from the Detroit Receiving Hospital and University Health Center, Detroit, report on their experience in a case series of 63 patients with a BMI of 30 or higher.

Despite a higher surgical risk and a 45% greater chance of complications, obese and very obese patients showed significant improvement in visual analog scale for back and leg pain with some improvement in disability scores independent of the BMI of the patient.

Thus, despite posing a greater challenge for the surgeon and slightly higher surgical risk, heavier patients stand to benefit as much from surgery as less obese patients.

Incidentally, as with other types of orthopedic surgeries that improve mobility, no “spontaneous” weight loss was found to occur after spinal surgery.

Important questions that remain to be answered include the role for pre-surgical weight loss and whether or not weight management will be made easier following surgery.

AMS
Edmonton, Alberta

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2 Comments

  1. Hi Dr. Sharma,

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    OHA Staff

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  2. The increased morbidity has to be viewed in light of the generally poor long term results of fusion for back pain in patients without preoperative instability, regardless of body mass index.

    There is no more important treatment goal for any obese patient than weight loss.

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