Bariatric Surgery and Low Back Pain: A Systematic Literature Review

Andrei Fernandes Joaquim, Peter Helvie, Alpesh A Patel, Andrei Fernandes Joaquim, Peter Helvie, Alpesh A Patel

Abstract

Study design: Systematic literature review.

Objective: It is estimated that one third of the world population is overweight and 20% of adults have some low back symptoms at some point of their lives. The association of obesity and low back pain and physical deterioration has been well established. We designed this study to evaluate the role of bariatric surgery (BS) for lumbar spine symptoms in obese patients.

Methods: A systematic literature review was performed using the PubMed database identifying lumbar spine symptoms (pain, functional status, disability index) and/or complications of lumbar spine surgery before and after BS. Study quality was assessed according to the Oxford Centre for Evidence-Based Medicine.

Results: Ten studies were identified. Nine evaluated the role of BS in low back pain and/or functional status before and after surgery: all reported that bariatric surgery had a positive impact in improving low back pain symptoms and decreasing disability in severely obese patients. One study evaluated the role of posterior lumbar surgery in patients who were obese at the time of surgery and those who had a previous bariatric procedure: bariatric surgery decreased postoperative surgical complications. The level of the evidence was low (III and IV).

Conclusions: Bariatric surgery in severely obese patients decreases the intensity of low back symptoms and also decreases disability secondary to back problems. Additionally, bariatric surgery may be advantageous for patients who need a posterior lumbar surgery and are severely obese. Prospective studies with longer follow-up are necessary to confirm this conclusion.

Keywords: bariatric surgery; low back pain; obesity; relationship.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Alpesh A. Patel discloses the following: Consulting: Zimmer Biomet, DePuy Synthes, nView, Amedica, Kuros Biosciences; Product Design/Royalties: Nuvasive, Zimmer Biomet, Amedica; Stock options/Ownership (<1%): Amedica, Vital5, Nocimed, Cytonics, Tissue Differentiation Intelligence, Endoluxe, nView; Institutional Fellowship Program Support: NuVasive, AO Spine North America; Board of Directors (non-financial): Cervical Spine Research Society, Lumbar Spine Research Society Editorial Board; and Contemporary Spine Surgery: Journal of American Academy of Orthopaedic Surgery (Deputy Editor).

© The Author(s) 2019.

Figures

Figure 1.
Figure 1.
Flow chart of our search mechanism.

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Source: PubMed

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