Case Managers Corner

Surgical Complications

All surgical procedures carry risks or complications. Please be advised that this is not intended to be a complete list of potential complications.

Anesthesia

During surgery the patient is given medications that can result in a reaction as well as difficulties during the physical induction process of intubation and extubation. The medications can affect the function of the lungs since they do not expand as well when under anesthesia. Please discuss your concerns with your physician as well as an anesthesiologist.

Blood Clots – also referred to as DVT (deep vein thrombosis)

This can occur following any surgery and when blood in a large vein clots. Typically, if this occurs, the legs are the effected extremity. Locally, the leg can swell and become painful and warm to the touch. If the clot breaks it can travel to the lungs resulting in a pulmonary embolism.

There are methods to reduce the risk of clot formation, which include use of compression stockings and early mobilization with walking, standing and ankle flexing. We encourage post-operative patients to continue to wear pressure stockings until up and ambulating and/or walking as normally as what was performed prior to the development of the spinal condition for which surgery was performed. If the patient is not able to walk around in a normal fashion through most of the waking day, the patient should wear these pressure stockings to prevent the risk of developing a blood clot. With most spinal surgery we are not able to provide chemical anticoagulation such as heparin, Coumadin, or aspirin. For this reason our only means to prevent the development of a blood clot is mechanical treatments such as thigh high TEDS or compression stockings as well as ankle pumps and good old fashion exercise. Please contact a member of the Taylor Spine Team if you have any questions regarding the need and the importance of pressure stockings after your spinal surgery.

Nerve Damage

Because of the location of a spine surgery, there is a risk that a spinal nerve or the spinal cord can be damaged by irritating the nerve when manipulating it or cutting the nerve tissue. This can result in loss of sensation and muscle weakness in the area that that nerve enervates.

Infection

Infection at the level of the spine is a serious complication that may require additional testing, antibiotics and further surgery. An infection at the site of surgery usually results in drainage from the wound, redness and swelling around the wound, fever and increased pain.

Dr. Taylor feels that the hospital is by definition a contaminated environment. Dr. Taylor has this opinion because many of the multi-drug resistant organisms such as MRSA and VRE are highly prevalent in hospital environments. Because health care providers must care for individuals with these infections as well as individuals who are not infected, you are at a greater risk of developing a dangerous infection while you remain in a hospital. For this reason, once your pain is controlled on oral medications, you can ambulate safely, and you have successfully voided as it relates to bowel and urinary function you should, in Dr. Taylor's opinion, leave the hospital and go to your home which is a much cleaner environment than the hospital. If you have any additional questions about Dr. Taylor's feelings on hospital acquired infections please ask a member of the Taylor Spine Team.

Hardware Failure

Any hardware or graft utilized in surgery is checked for placement prior to completing the procedure, but has the potential to migrate, loosen or fracture. These changes in position can irritate the nerves and/or tissue and may require another surgery to solve the problem

Failed or Non-union

The graft and hardware that may be utilized in a fusion surgery may not heal correctly. This is called a non-union, failed union or pseudoarthrosis. If motion continues to cause pain or there is a concern regarding stability of the spine, a second surgery may be required. There are several factors that increase a patient’s risk of a Non-Union.

Dr. Taylor feels that your risk of a nonunion is greatly increased if you abuse nicotine products, if you have other medical conditions such as rheumatoid arthritis and/or diabetes. As well if you take certain medications such as steroid medications as well as certain medications to treat systemic inflammatory arthritis. These other conditions may greatly increase your risk of a failure of the fusion. In addition if the Dr. Taylor Spine Team has asked you to wear a brace we would ask that you wear that brace in compliance with our instructions. Failure to do so may further increase your risk of a poor outcome and/or nonunion. Finally a bone stimulator may be provided to you after your spinal surgery. If you are not compliant with the use of the bone stimulator it may greatly increase your risk of a nonunion and a poor outcome.

Risks of Surgery

Dr. Taylor encourages patients to understand fully the risks of surgery before proceeding with any type of surgical intervention. Below you will find a brief list of some of the many complications which can occur with spine surgery. Please review these complications and discuss with Dr. Taylor further any questions or concerns you have regarding your particular case.

The risks of surgery include: Risks of allograft bone include: Risks associated with surgery from the front of the spine through the abdomen include:
Risks associated with metal implants in the spine include: Risks of surgery on the spine include: Risks associated with neck surgery include: Risks of Infuse Bone Morphogenic Protein include: back to Anterior Lumbar Total Replacement

The material of this Web Site is for general education only and is not meant to replace an evaluation by a healthcare provider. This site is not meant as a method to practice medicine, provide medical services or advice. You should always talk to your health care professional.