Post-panniculectomy improvement in low back pain: A Case Report

Post-panniculectomy improvement in low back pain: A Case Report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Post-panniculectomy improvement in low back pain: A Case Report Lauren Marquette, Marc Skylsen This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4623452/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 3 You are reading this latest preprint version Abstract While abdominoplasty is traditionally considered a cosmetic surgery, there has been growing interest in the potential role of abdominoplasty for the treatment of low back pain. We present a case of a 69 year old man with a history of over 10 years of significant low back pain with radiculopathy resistant to various conservative measures as well as multiple surgeries for spinal decompression. Fourteen years after bariatric surgery and having maintained a stable BMI, he presented with a large pannus desiring abdominoplasty for aesthetic reasons. He underwent an abdominoplasty with panniculectomy only which was uncomplicated. As an unintended benefit of his procedure, he reported on his one month post op visit that he had near resolution of his low back pain and radiculopathy. He had rated his pre-op back pain as 7/10 and reported that it now had been reduced to 1-2/10. More research needs to be done to assess the potential of abdominoplasty as a treatment for low back pain in patients with massive weight loss. Key points Some small studies have demonstrated that panniculectomy may have a secondary benefit of pain reduction in patients with chronic low back pain. We present the case of a patient with chronic low back pain which was resistant to multiple treatment methodologies including surgery who underwent panniculectomy after significant post bariatric surgery weight loss. After years of chronic pain, this patient reported a significant decrease in low back pain and radiculopathy symptoms after undergoing panniculectomy. Further research should be performed to evaluate the potential of abdominoplasty as a treatment option for chronic, treatment resistant low back pain. Background Historically panniculectomy has largely been considered a cosmetic surgery with a narrow scope of medical indications including intertrigo and other recurrent skin and soft tissue infections. They are often performed in the aftermath of bariatric weight loss surgery. Interest in the use of abdominoplasty as a treatment for back pain has grown, however, current research on the effect of panniculectomy on chronic low back pain is limited. Some more recent small studies have shown that abdominoplasty can lead to long term improvements in low back pain and even urinary incontinence (Taylor, 2018 ). Particularly in patients who have failed conservative measures. However, the majority of data supporting improvement in low back pain with abdominoplasty is focused on the rectus plication portion of the procedure (O’Neal, 2011) and in patients with rectus diastasis as a consequence of pregnancy (Tuominen, 2023 ). This is likely due to the theory that rectus plication would improve abdominal muscle efficacy and strength and thereby increase support for the lumbar spine. As such, even less is known about the impact of the panniculectomy portion of an abdominoplasty alone on low back pain. Case Description We present the case of a 69 year old man with a history of over 10 years of significant low back pain with radiculopathy. This significantly altered his quality of life and functionality including frequent falls and difficulty with mobility requiring a cane for ambulation. Prior to his presentation in clinic he had previously undergone several interventions and surgeries for his back pain including L2 kyphoplasty in 2017, caudal ESI in 2019, ACDF 3–6 in 2020, L3 laminectomy in 2020, and c4-t2 fusion and c5-7 laminectomy for cervical stenosis in 2021 and multiple courses of physical therapy and aqua therapy. Despite these interventions he continued to have significant low back pain and radiculopathy symptoms leading to multiple emergency room visits including evaluation for intermittent bowel and bladder incontinence. Imaging completed in the ER demonstrated chronic L2-3 compression fractures and stable post surgical changes. Other medical history includes congestive heart failure, type 2 diabetes mellitus, coronary arterial disease with a history of myocardial infarction, and osteoarthritis. The patient had undergone Roux-en-Y gastric bypass in 2009 and experienced significant weight loss of 220 lbs (fifty percent of his total body weight). Due to this weight loss he had a significant pannus with ptosis leading him to seek out a panniculectomy primarily for aesthetic reasons. He had maintained his weight loss overtime and had a consistent weight for the last 4 years. After preoperative evaluation and consideration of his risk factors he was considered to be an appropriate candidate for panniculectomy and elected to undergo the procedure. Operation In 2023, the patient underwent panniculectomy with a large horizontal ellipse incision. The umbilicus with the associated stalk was isolated and protected during development of the flap and then delivered through an appropriately sized incision. Two 10F JP drains were placed in the subcutaneous space and the skin was closed with 2 − 0 vicryl, 3 − 0 monocryl deep dermals, and finally 3 − 0 stratafix running subcuticular closure. The patient tolerated the procedure well without complications and was discharged home. He recovered from surgery without complications and presented to his scheduled follow up appointment. Follow up On 4 week post op follow up, The incision sites including the umbilicus are well approximate and well healing without signs of infection or seroma. He was tolerating a diet and his pain was well controlled. He had returned to his baseline level of activity and function. Both JP drains were removed on this first post op visit. The patient reported that he had experienced near total resolution of his lower back pain and radiculopathy. He rated his pre-op back pain as 7/10 and reported that it now had been reduced to 1–2/10. This was an unintended and unforeseen benefit of his procedure. Discussion Other case reports have demonstrated significant improvements in back pain and spinal stenosis symptoms after abdominoplasty. For example, Petrakis et al. ( 2016 ) reported a case of a woman with chronic low back pain, radiculopathy and urinary incontinence who experienced resolution of her back pain and urinary incontinence as well as significant improvement in her radiculopathy after a surgical intervention which included umbilical hernia repair, panniculectomy, and abdominal wall plication. These case reports have particularly focused on the potential for improvement in low back pain for patients who have failed other more conservative measures of low back pain. The patient we have presented had certainly failed conservative measures such as physical therapy and aquatherapy. In addition, he failed multiple surgeries considerably more aggressive than abdominoplasty including laminectomy, kyphoplasty and several spinal fusion procedures. Additionally, case reports and research pursuits have generally focused on abdominal wall plication specifically and its potential to improve back pain. For example Oneal et al. in 2011 presented 8 cases of women who had failed conservative management of back pain who demonstrated significant improvement in back pain after plication. They suggested a spine stabilizing effect through tightening the muscles of the lateral abdominal complex, which increases intra abdominal pressure. Secondly, increasing the efficiency of abdominal muscles so that they can more effectively act to stabilize the spine. However, in this particular case as discussed we demonstrate significant improvement of long standing back pain and radiculopathy after panniculectomy alone without rectus muscle plication. In fact, a recent study performed by Soteropulos et al. (2020) at University of Wisconsin looked at the reduction of back pain based on the Oswestry Disability Index in patients who underwent abdominoplasty and found that weather or not rectus plication was performed had no impact on the effect size of back pain reduction. We postulate that the excess weight of the pannus which applies leverage on the spine due to its distance from the central axis may also play a more significant role in chronic back pain symptoms than previously thought. Removal of this leverage and shifting of the center of gravity closer to the spine by way of panniculectomy procedure, may effectively improve back pain symptoms. Conclusions In conclusion, the patient described demonstrated a significant improvement in back pain and radiculopathy after panniculectomy alone. We suggest that the impact of the pannus itself on chronic low back pain may be underestimated and that abdominoplasty, particularly in patients who have failed conservative measures, should continue to be examined for its potential in elevation of low back pain. Declarations Ethics All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from the individual whose case was presented in the study. The authors declare that they have no conflict of interest. No funding was received, used, or petitioned for as part of this project. Author Contribution L.M. is the patients surgeon and contributed the information for the case, obtained consent from the pateint and edited the manuscript. M.S. wrote the main manuscript text. All authors reviewed the manuscript. References Oneal R.M., Mulka J.P., Sharpino P., Hing D., Cavaliere C (2011). Wide abdominoplasty rectus plication – abdominoplasty for the treatment of chronic intractable low back pain. Plast. Reconstr. Surg. 2011;127(1):225–231. Petrakis I, Xenaki S, Andreou A, Panagiotakis G, Chalkiadakis G (2016). Therapeutic abdominoplasty: Report of a case. Int J Surg Case Rep. 2015;8C:96 – 9. doi: 10.1016/j.ijscr.2015.01.039 . Epub 2015 Jan 28. PMID: 25644558; PMCID: PMC4353935. Soteropulos, Carol E (11/2020). "Improvement in Back Pain Following Abdominoplasty: Results of a 10-Year, Single-Surgeon Series". Aesthetic Surgery Journal (1090-820X), 40 (12), p. 1309. Taylor, D. Alastair (2018). "Abdominoplasty Improves Low Back Pain and Urinary Incontinence". Plastic and reconstructive surgery (1963) (0032-1052), 141 (3), p. 637. Tuominen, Reetta (2023). "“An abdominoplasty modification for post-pregnancy abdomen with rectus diastasis and midline hernia: the technique and results”". Plastic and reconstructive surgery (1963) (0032-1052), Publish Ahead of Print. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editor assigned by journal 03 Jul, 2024 Submission checks completed at journal 27 Jun, 2024 First submitted to journal 22 Jun, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4623452","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":322146743,"identity":"b82354e6-cba9-461d-a2a2-cb09283ba99a","order_by":0,"name":"Lauren Marquette","email":"","orcid":"","institution":"Michigan Medicine","correspondingAuthor":false,"prefix":"","firstName":"Lauren","middleName":"","lastName":"Marquette","suffix":""},{"id":322146744,"identity":"4d533ed2-61fc-46f4-a828-b8dc52274c32","order_by":1,"name":"Marc Skylsen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyklEQVRIiWNgGAWjYHACZgaGAiDF3mBAihaQYp4DJGuRSCBSi2778cfGPAZ1cuaSj7du+MFgky/vQECL2Zkc42Qeg8PGlrPTym72MKRZbjxASMuBHObDPAYHEjfczjG7zcBw2MCwgZCW888fA7XU1W+4eYZYLTcSQA5jTjC4wQPRIk9AB1DLG2PDOQaHDTecAfnFIM2AYLiZnU9/LPGmok7e4PjhbTd+VNgYyBNyGAgw8cCZQCsMDhChhfEHMo8oW0bBKBgFo2BEAQCrEEE1aT+y3wAAAABJRU5ErkJggg==","orcid":"","institution":"Wayne State University","correspondingAuthor":true,"prefix":"","firstName":"Marc","middleName":"","lastName":"Skylsen","suffix":""}],"badges":[],"createdAt":"2024-06-23 01:23:36","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4623452/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4623452/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":60690810,"identity":"a9346c36-6bec-48dc-a262-37527b9faea7","added_by":"auto","created_at":"2024-07-19 15:00:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":165993,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4623452/v1/01a53a16-6dd9-493c-b7ba-1bc3f46e2ee9.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Post-panniculectomy improvement in low back pain: A Case Report","fulltext":[{"header":"Key points ","content":"\u003cul\u003e\n \u003cli\u003eSome small studies have demonstrated that panniculectomy may have a secondary benefit of pain reduction in patients with chronic low back pain.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eWe present the case of a patient with chronic low back pain which was resistant to multiple treatment methodologies including surgery who underwent panniculectomy after significant post bariatric surgery weight loss.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAfter years of chronic pain, this patient reported a significant decrease in low back pain and radiculopathy symptoms after undergoing panniculectomy.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eFurther research should be performed to evaluate the potential of abdominoplasty as a treatment option for chronic, treatment resistant low back pain.\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Background","content":"\u003cp\u003eHistorically panniculectomy has largely been considered a cosmetic surgery with a narrow scope of medical indications including intertrigo and other recurrent skin and soft tissue infections. They are often performed in the aftermath of bariatric weight loss surgery. Interest in the use of abdominoplasty as a treatment for back pain has grown, however, current research on the effect of panniculectomy on chronic low back pain is limited. Some more recent small studies have shown that abdominoplasty can lead to long term improvements in low back pain and even urinary incontinence (Taylor, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Particularly in patients who have failed conservative measures. However, the majority of data supporting improvement in low back pain with abdominoplasty is focused on the rectus plication portion of the procedure (O\u0026rsquo;Neal, 2011) and in patients with rectus diastasis as a consequence of pregnancy (Tuominen, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). This is likely due to the theory that rectus plication would improve abdominal muscle efficacy and strength and thereby increase support for the lumbar spine. As such, even less is known about the impact of the panniculectomy portion of an abdominoplasty alone on low back pain.\u003c/p\u003e"},{"header":"Case Description","content":"\u003cp\u003eWe present the case of a 69 year old man with a history of over 10 years of significant low back pain with radiculopathy. This significantly altered his quality of life and functionality including frequent falls and difficulty with mobility requiring a cane for ambulation. Prior to his presentation in clinic he had previously undergone several interventions and surgeries for his back pain including L2 kyphoplasty in 2017, caudal ESI in 2019, ACDF 3\u0026ndash;6 in 2020, L3 laminectomy in 2020, and c4-t2 fusion and c5-7 laminectomy for cervical stenosis in 2021 and multiple courses of physical therapy and aqua therapy. Despite these interventions he continued to have significant low back pain and radiculopathy symptoms leading to multiple emergency room visits including evaluation for intermittent bowel and bladder incontinence. Imaging completed in the ER demonstrated chronic L2-3 compression fractures and stable post surgical changes. Other medical history includes congestive heart failure, type 2 diabetes mellitus, coronary arterial disease with a history of myocardial infarction, and osteoarthritis.\u003c/p\u003e \u003cp\u003eThe patient had undergone Roux-en-Y gastric bypass in 2009 and experienced significant weight loss of 220 lbs (fifty percent of his total body weight). Due to this weight loss he had a significant pannus with ptosis leading him to seek out a panniculectomy primarily for aesthetic reasons. He had maintained his weight loss overtime and had a consistent weight for the last 4 years. After preoperative evaluation and consideration of his risk factors he was considered to be an appropriate candidate for panniculectomy and elected to undergo the procedure.\u003c/p\u003e\n\u003ch3\u003eOperation\u003c/h3\u003e\n\u003cp\u003eIn 2023, the patient underwent panniculectomy with a large horizontal ellipse incision. The umbilicus with the associated stalk was isolated and protected during development of the flap and then delivered through an appropriately sized incision. Two 10F JP drains were placed in the subcutaneous space and the skin was closed with 2\u0026thinsp;\u0026minus;\u0026thinsp;0 vicryl, 3\u0026thinsp;\u0026minus;\u0026thinsp;0 monocryl deep dermals, and finally 3\u0026thinsp;\u0026minus;\u0026thinsp;0 stratafix running subcuticular closure. The patient tolerated the procedure well without complications and was discharged home. He recovered from surgery without complications and presented to his scheduled follow up appointment.\u003c/p\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eFollow up\u003c/h2\u003e \u003cp\u003eOn 4 week post op follow up, The incision sites including the umbilicus are well approximate and well healing without signs of infection or seroma. He was tolerating a diet and his pain was well controlled. He had returned to his baseline level of activity and function. Both JP drains were removed on this first post op visit. The patient reported that he had experienced near total resolution of his lower back pain and radiculopathy. He rated his pre-op back pain as 7/10 and reported that it now had been reduced to 1\u0026ndash;2/10. This was an unintended and unforeseen benefit of his procedure.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eOther case reports have demonstrated significant improvements in back pain and spinal stenosis symptoms after abdominoplasty. For example, Petrakis et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) reported a case of a woman with chronic low back pain, radiculopathy and urinary incontinence who experienced resolution of her back pain and urinary incontinence as well as significant improvement in her radiculopathy after a surgical intervention which included umbilical hernia repair, panniculectomy, and abdominal wall plication. These case reports have particularly focused on the potential for improvement in low back pain for patients who have failed other more conservative measures of low back pain. The patient we have presented had certainly failed conservative measures such as physical therapy and aquatherapy. In addition, he failed multiple surgeries considerably more aggressive than abdominoplasty including laminectomy, kyphoplasty and several spinal fusion procedures.\u003c/p\u003e \u003cp\u003eAdditionally, case reports and research pursuits have generally focused on abdominal wall plication specifically and its potential to improve back pain. For example Oneal et al. in 2011 presented 8 cases of women who had failed conservative management of back pain who demonstrated significant improvement in back pain after plication. They suggested a spine stabilizing effect through tightening the muscles of the lateral abdominal complex, which increases intra abdominal pressure. Secondly, increasing the efficiency of abdominal muscles so that they can more effectively act to stabilize the spine. However, in this particular case as discussed we demonstrate significant improvement of long standing back pain and radiculopathy after panniculectomy alone without rectus muscle plication. In fact, a recent study performed by Soteropulos et al. (2020) at University of Wisconsin looked at the reduction of back pain based on the Oswestry Disability Index in patients who underwent abdominoplasty and found that weather or not rectus plication was performed had no impact on the effect size of back pain reduction. We postulate that the excess weight of the pannus which applies leverage on the spine due to its distance from the central axis may also play a more significant role in chronic back pain symptoms than previously thought. Removal of this leverage and shifting of the center of gravity closer to the spine by way of panniculectomy procedure, may effectively improve back pain symptoms.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn conclusion, the patient described demonstrated a significant improvement in back pain and radiculopathy after panniculectomy alone. We suggest that the impact of the pannus itself on chronic low back pain may be underestimated and that abdominoplasty, particularly in patients who have failed conservative measures, should continue to be examined for its potential in elevation of low back pain.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch3\u003e\u003cstrong\u003eEthics\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from the individual whose case was presented in the study. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest.\u003c/p\u003e\n\u003cp\u003eNo funding was received, used, or petitioned for as part of this project.\u0026nbsp;\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eL.M. is the patients surgeon and contributed the information for the case, obtained consent from the pateint and edited the manuscript. M.S. wrote the main manuscript text. All authors reviewed the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOneal R.M., Mulka J.P., Sharpino P., Hing D., Cavaliere C (2011). Wide abdominoplasty rectus plication \u0026ndash; abdominoplasty for the treatment of chronic intractable low back pain. \u003cem\u003ePlast. Reconstr. Surg.\u003c/em\u003e 2011;127(1):225\u0026ndash;231.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePetrakis I, Xenaki S, Andreou A, Panagiotakis G, Chalkiadakis G (2016). Therapeutic abdominoplasty: Report of a case. Int J Surg Case Rep. 2015;8C:96\u0026thinsp;\u0026ndash;\u0026thinsp;9. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ijscr.2015.01.039\u003c/span\u003e\u003cspan address=\"10.1016/j.ijscr.2015.01.039\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2015 Jan 28. PMID: 25644558; PMCID: PMC4353935.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSoteropulos, Carol E (11/2020). \"Improvement in Back Pain Following Abdominoplasty: Results of a 10-Year, Single-Surgeon Series\". Aesthetic Surgery Journal (1090-820X), 40 (12), p. 1309.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTaylor, D. Alastair (2018). \"Abdominoplasty Improves Low Back Pain and Urinary Incontinence\". Plastic and reconstructive surgery (1963) (0032-1052), 141 (3), p. 637.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTuominen, Reetta (2023). \"\u0026ldquo;An abdominoplasty modification for post-pregnancy abdomen with rectus diastasis and midline hernia: the technique and results\u0026rdquo;\". Plastic and reconstructive surgery (1963) (0032-1052), Publish Ahead of Print.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"obesity-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"obsu","sideBox":"Learn more about [Obesity Surgery](https://link.springer.com/journal/11695)","snPcode":"11695","submissionUrl":"https://submission.springernature.com/new-submission/11695/3","title":"Obesity Surgery","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-4623452/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4623452/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eWhile abdominoplasty is traditionally considered a cosmetic surgery, there has been growing interest in the potential role of abdominoplasty for the treatment of low back pain. We present a case of a 69 year old man with a history of over 10 years of significant low back pain with radiculopathy resistant to various conservative measures as well as multiple surgeries for spinal decompression. Fourteen years after bariatric surgery and having maintained a stable BMI, he presented with a large pannus desiring abdominoplasty for aesthetic reasons. He underwent an abdominoplasty with panniculectomy only which was uncomplicated. As an unintended benefit of his procedure, he reported on his one month post op visit that he had near resolution of his low back pain and radiculopathy. He had rated his pre-op back pain as 7/10 and reported that it now had been reduced to 1-2/10. More research needs to be done to assess the potential of abdominoplasty as a treatment for low back pain in patients with massive weight loss.\u003c/p\u003e","manuscriptTitle":"Post-panniculectomy improvement in low back pain: A Case Report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-19 14:52:14","doi":"10.21203/rs.3.rs-4623452/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorAssigned","content":"","date":"2024-07-03T09:47:06+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-28T00:28:47+00:00","index":"","fulltext":""},{"type":"submitted","content":"Obesity Surgery","date":"2024-06-23T01:22:12+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"obesity-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"obsu","sideBox":"Learn more about [Obesity Surgery](https://link.springer.com/journal/11695)","snPcode":"11695","submissionUrl":"https://submission.springernature.com/new-submission/11695/3","title":"Obesity Surgery","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"4e5f651d-e85f-4179-9b79-be2bb745479b","owner":[],"postedDate":"July 19th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-07-19T14:52:14+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-19 14:52:14","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4623452","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4623452","identity":"rs-4623452","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}