I weigh about 400 pounds. Before I can have back surgery, my surgeon wants me to lose at least 100 pounds. I don't really see that 100 pounds could make that much difference. What do you think?

Obesity has been shown to be a risk factor for complications after surgery of any kind. Specific studies of spine surgery have shown the same thing.

There are several technical challenges. First, clear imaging studies needed before surgery can be hard to obtain. The MRI machines don't always accommodate large sizes. A similar problem can occur with X-rays. The machine isn't large enough to take pictures of the spine as the patient bends and straightens.

Large amounts of fat make it more difficult to find veins and arteries. The same problem exists when trying to keep the airway open during anesthesia.

There is a known link between diabetes or high blood pressure and surgical complications. Obese patients are more likely to suffer either or both of these problems as a result of their obesity.

Not all studies show a direct link between obesity and surgical complications. Each physician must carefully choose patients for surgery. Obesity is just one of many risk factors to consider.

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