My husband is a very large man (almost 300 pounds). He’s going to have spine surgery to fuse his low back at L45. The surgical nurse told us he would be placed face down during the operation. He’s never on his stomach because it’s so uncomfortable. How is this going to work?

Sometimes patients having lumbar fusion are placed prone (face down) over chest rolls. This is done to get the right position in the spine during the procedure. But it can be used for larger patients who cannot lie flat.

In the very obese adult, lying prone even with the rolls may not give the viscera (organs) enough room. In such cases, a special table can be used. This table places the patient in a prone-kneeling position. A special support is placed along the sides and under the arms. The belly is free to hang down without any pressure.

This position is important because it helps reduce bleeding into the spine. The surgical team will be monitoring your husband throughout the procedure. The anesthesiologist makes sure the patient is getting enough oxygen. Vital signs are taken routinely. Any sign of discomfort will be recognized and dealt with right away.