BMJ Case Reports 2018; doi:10.1136/bcr-2017-223629
  • Novel treatment (new drug/intervention; established drug/procedure in new situation)

Improvement of thoracic myelopathy following bariatric surgery in an obese patient

  1. Takashi Kaito1
  1. 1Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
  2. 2Orthopaedic Surgery, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
  1. Correspondence to Dr Shota Takenaka, show{at}
  • Accepted 6 April 2018
  • Published 11 April 2018


Revision spine surgery is extremely challenging in super-super obese patients (body mass index (BMI) ≥60 kg/m2). This is the first report describing how bariatric surgery was useful for a super-super obese patient with progressing myelopathy. A 44-year-old man with a BMI of 62.9 kg/m2 presented with an ambulatory disorder caused by thoracic ossification of the posterior longitudinal ligament (T7–8). Before this paraparesis, he had undergone four spinal operations, and was not considered a good candidate for a fifth spine surgery. At the time of the fourth operation, he had reached a maximum weight of 205 kg (BMI 69.3 kg/m2). Instead, he underwent a laparoscopic sleeve gastrectomy. Sixteen months later, his body weight had decreased to BMI 35.2 kg/m2, and he could walk without a walker. In addition to reducing our patient’s load, a ‘non-operative’ form of dekyphosis due to altered thoracic spinal alignment secondary to weight loss may explain the improvement in his myelopathy.


  • Contributors ST interpreted the data for the paper, drafted the manuscript and approved the final manuscript for submission. YM has helped writing the manuscript. NH has helped to critically revise the manuscript. TK helped revising the manuscript and approved it for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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