PT  - JOURNAL ARTICLE
AU  - Shota Takenaka
AU  - Yoshihiro Mukai
AU  - Noboru Hosono
AU  - Takashi Kaito
TI  - Improvement of thoracic myelopathy following bariatric surgery in an obese patient
AID  - 10.1136/bcr-2017-223629
DP  - 2018 Apr 11
TA  - BMJ Case Reports
PG  - bcr-2017-223629
VI  - 2018
4099  - http://casereports.bmj.com/content/2018/bcr-2017-223629.short
4100  - http://casereports.bmj.com/content/2018/bcr-2017-223629.full
AB  - 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.