Overweight Patients and Back Surgery

Overweight Patients and Back Surgery

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Being overweight may contribute to back pain.

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Back surgery may help relieve pain related to an injury, spinal deformity, arthritis or a slipped disc. If your back condition does not require emergency surgery, health care providers typically recommend a combination of exercise, physical therapy and medication to alleviate your symptoms. You may also be advised to lose weight if your body mass index, or BMI, is 25 or higher. If these measures do not help, surgery may be a consideration.

Excess Weight and Back Pain

Obese people -- those with a BMI of 30 or higher -- are more likely to have low back pain than people with a BMI in the normal range. The risk is highest in morbidly obese people with a BMI of 40 or greater. Overweight people, with a BMI of 25 to 29.9, may have a slightly elevated risk of low back pain, however, this has not been proven conclusively.

Although excess weight is a risk factor, there is no scientific evidence that it causes low back pain. Other conditions that may require back surgery, such as trauma or spinal deformities, are not related to being overweight or obese.

Back Surgery

Back surgery may be needed to correct spinal conditions that were present at birth, to repair damage to the spine after an injury or to relieve pressure on spinal nerves. Some back surgery procedures must be performed using an open technique that involves a single, large incision, while others can be done using minimally invasive techniques. Back surgery procedures often take several hours to complete, increasing the possibility that the patient may develop complications during or after the operation.


Recognized complications of back surgery include blood clots in the legs, pneumonia and wound infections. People with excess weight are more likely to have conditions such as diabetes or high blood pressure, both of which increase the risk of developing surgical complications.

These risks are much higher in severely obese people than in those whose BMI falls into the overweight category. A review published in the March 2012 issue of "The American Journal of Orthopedics" found complication rates after spinal fusion surgery of 14 percent in overweight patients, 20 percent in obese patients and 36 percent in morbidly obese patients.


The success of back surgery may be measured in terms of a person's overall satisfaction level, pain, use of pain medication and ability to walk. In an article published in "Spine" in March 2013, researchers reported the results of a study of 2,633 patients who had undergone spinal surgery. The investigators classified participants as normal weight, overweight or obese according to their BMI. Two years after surgery, they found that the obese group was less satisfied with the surgery, had more back and leg pain, and used more pain medication than the other groups.

Comparing the normal weight and overweight patients, there was little difference in pain levels, but the overweight group used more pain medication. With regard to walking ability, approximately half of the patients in each group were able to walk better two years after the surgery. The researchers concluded that back surgery should not be withheld on the basis of excess weight, but that obese patients should be encouraged to lose weight to improve the likelihood of a satisfactory outcome.