Improvement of thoracic myelopathy following bariatric surgery in an obese patient

BMJ Case Rep. 2018 Apr 11:2018:bcr2017223629. doi: 10.1136/bcr-2017-223629.

Abstract

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.

Keywords: obesity (public Health); orthopaedics; spinal cord.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bariatric Surgery*
  • Body Mass Index
  • Gastrectomy*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Obesity, Morbid / complications
  • Obesity, Morbid / surgery*
  • Paraplegia / etiology
  • Reoperation
  • Spinal Cord Compression / diagnostic imaging
  • Spinal Cord Compression / etiology
  • Spinal Cord Diseases / complications
  • Spinal Cord Diseases / surgery*
  • Treatment Outcome
  • Weight Loss