Challenges of spine surgery in obese patients

Obesity, one of the most common health problems in the United States, is becoming more prevalent. At the same time, because of technological advances, the rate of spine surgeries is on the rise. Given these trends in obesity and spine surgeries, it can be inferred that the number of obese patients who undergo spine surgeries will increase as well. When spine surgeries are planned for obese patients, several factors must be considered. Obesity is closely correlated with additional medical comorbidities including hypertension, coronary artery disease, and diabetes mellitus. Preoperative evaluation may be more difficult, as more extensive medical testing may be needed. Adequate radiographic images can be difficult to obtain because of patient size and equipment limitations. Administering anesthesia becomes more difficult, as does proper patient positioning. After surgery, obese patients are at higher risk for wound infection and deep vein thrombosis. Nevertheless, appropriate clinical outcomes can be achieved in obese patients who undergo spine surgery. Obesity is not a contraindication for spine surgery. Patient selection is key in achieving favorable clinical outcomes.