Bariatric care has to do with the medical care of patients who are considered overweight by 100-200 pounds or weigh more than 300 pounds. It does not appear that being overweight leads to a greater risk of back pain. Bariatric patients are just as likely as others to have back problems and may still need surgery. For many bariatric patients, however, having the surgery they need may be difficult.
Unique issues facing the bariatric patient
Bariatric patients requiring spine surgery generally have a difficult time obtaining the operation they need. There are aspects to the bariatric patient that make conventional spine surgery riskier. Bariatric patients are more likely to develop wound complications than other patients. Wounds may partially open (called wound dehiscence) or may become infected. Bariatric patients are also more likely to develop a number of other post-operative complications (heart, lung, blood clots, etc) and are more likely to require hospital re-admission within 30 days of surgery. Research has estimated the risk of any one post-operative complication as being nearly double the regular population. Wound complications occur about three times more frequently than in the regular patient population.
Because of the increased risk of having a complication with conventional spine surgery, bariatric patients often see their surgeries being deferred until patients achieve radical weight loss goals. The weight loss goals themselves are frustrating because it is typically very difficult for a patient in chronic pain to lose weight. Patients often have to turn to invasive surgical weight loss procedures to lose enough weight to qualify for surgery.
Post-surgery mobility is also very important to the bariatric patient. Requiring prolonged rest may increase the likelihood of urinary infections, breathing problems or leg vein clotting problems.
NeuroEndospine surgery for the bariatric patient
NeuroEndospine surgery requires a “band-aid” incision of 7mm to access the spine. A small tube with a lens is placed through the incision and the surgeon visualizes the surgery from inside the spine via a high-definition camera. The depth of the surgical tube to reach the spine is inconsequential. Because the incision is kept small, the risk of wound complications after surgery is greatly reduced.
The smaller incision and surgical approach also means that patients have increased mobility after surgery. Patients do not generally require bedrest after surgery. The only activity limitations are heavy lifting and strenuous activity. Patients may walk and perform light exercise the day after surgery. As a result, the increased mobility after surgery prevents the complications seen in less mobile post-operative patients.
In addition to the benefits of increased mobility and less peri-operative complications, bariatric patients have the same benefits as anyone else who undergoes NeuroEndospine surgery. These include the ability to permanently treat spinal joint arthritis, avoiding spinal fusion, maintaining the normal core strength of the spine and avoiding collateral injury to spinal joints and ligaments.
- Bariatric patients are patients who may be 100-200 pounds overweight.
- Bariatric patients have triple the risk of surgical wound complications.
- NeuroEndospine surgery avoids wound complications by utilizing a very small (about 7mm) incision.
- Bariatric patients are at increased risk of medical problems after surgery due to diminished mobility.
- NeuroEndospine surgery reduces surgical risk by maintaining post-operative mobility, allowing walking and light exercise the next day.