Understanding the risks of spinal surgery

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Before considering spinal surgery, it’s crucial to understand both common and serious risks that could impact your health and quality of life.

While modern surgical techniques have advanced significantly, spinal procedures still carry substantial risks that deserve careful consideration.

Common complications and their frequency

Research shows that even routine spinal surgeries can lead to complications.

A comprehensive study published in the European Spine Journal tracking 917 patients found that 17.3% experienced major complications, with higher rates among elderly patients and those with multiple health conditions.

Risk of infection and how it impacts recovery

Surgical site infections remain one of the most serious potential complications.

According to research published in the Global Spine Journal, deep infections occur in 0.4% to 15% of spinal procedures and can lead to prolonged hospitalization, additional surgeries, and in rare cases, life-threatening complications. The cost to treat these complications may be as much as $20,785 per patient.

Your risk increases with longer operations and more extensive surgical procedures.

Hardware-related complications you should understand

Modern spinal surgeries often involve implanting metal hardware to stabilize the spine. A longitudinal study in the Journal of Clinical Medicine examining 1,235 patients over ten years found that 12% experienced hardware-related complications, including:

• Implant migration or loosening that required revision surgery
• Metal sensitivity reactions causing chronic pain
• Stress on adjacent vertebral segments leading to accelerated degeneration

Nerve damage risks and long-term implications

Perhaps the most concerning potential complication is nerve damage, which can result in:

• Chronic pain that may be worse than your original symptoms
• Weakness or paralysis in limbs
• Loss of bladder or bowel control
• Sexual dysfunction

The American Academy of Orthopedic Surgeons reports that while rare, permanent nerve damage occurs in approximately 1-2% of spinal surgeries, with temporary nerve issues affecting up to 5% of patients.

Blood loss and cardiovascular complications

Complex spinal procedures can involve significant blood loss. The Spine Journal study mentioned earlier found that procedures lasting more than four hours had a 16% risk of requiring blood transfusions. Additionally, prolonged anesthesia time increases the risks of:

• Deep vein thrombosis
• Pulmonary embolism
• Cardiac complications, especially in older patients

Failed Back Surgery Syndrome: A serious consideration

One of the most frustrating potential outcomes is Failed Back Surgery Syndrome (FBSS), where pain persists or worsens after surgery. Research indicates this affects between 20-40% of patients undergoing lumbar spine surgery. Your risk increases with:

• Multiple prior surgeries
• Smoking
• Obesity
• Depression or anxiety disorders

Recovery challenges and rehabilitation risks

The recovery period itself carries risks that many patients don’t initially consider. These include:

• Muscle deconditioning from reduced activity
• Depression related to pain and limited mobility
• Dependency on pain medication
• Complications from physical therapy

What you can do to minimize risks

While some risks are unavoidable, you can take steps to reduce your chances of complications:

• Quit smoking at least six weeks before surgery
• Achieve a healthy weight
• Control chronic conditions like diabetes
• Choose an experienced surgeon who regularly performs your specific procedure
• Follow pre- and post-operative instructions carefully

Conclusion

Understanding the serious risks associated with spinal surgery is crucial for making an informed decision about your treatment.

While many patients experience positive outcomes, the potential for complications remains significant.

The decision to undergo spinal surgery should involve careful consideration of all treatment options, thorough discussion with your healthcare providers, and realistic expectations about potential outcomes and risks.

Remember that less invasive alternatives may be appropriate for your condition and should be explored before committing to surgical intervention.

References

Barbanti-Brodano, G., Griffoni, C., Halme, J. et al. (2019) Spinal surgery complications. European Spine Journal

Nasser, R., Kosty, J.A., Shah, S., Wang, J., Cheng, J. (2018) Risk factors and prevention of surgical site infections following spinal procedures. Global Spine Journal

Veronesi, F., Sartori, M., Griffoni, C., Valacco, M., Tedesco, G., Davassi, P.F., Gasbarrini, A., Fini, M., Barbanti Brodano, G. (2022) Complications in spinal fusion surgery: a systematic review of clinically used cages. Journal of Clinical Medicine

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