All surgical procedures carry risks or complications. Please be advised that this is not intended to be a complete list of potential complications.
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:
- Harmful reactions to anesthesia
- Lung problems including inflammation, infection or collapse of the lung, blood clots in the lung
- Infections of the wound or the skin around the wound
- The wound may not heal and open
- The tissues around the wound may die
- There may be swelling
- Blood clots can form in the legs. These clots can travel to the lung or brain
- Inflammation of a vein
- Changes in heart rhythm, including heart attack and death
- Strokes
- Complications of pregnancy
- Seizures, convulsions
- Loss of memory, confusion
- Hallucinations
- Changes in mental ability
Risks of Allograft bone include:
- Transmission of hepatitis, HIV infection or AIDS
- Brain diseases
- Syphilis or bacterial infections
- Immune rejections
- Resporption of the transplanted tissue resulting in breakdown of the bone
Risks associated with surgery from the front of the spine through the abdomen include:
- Damage to the tissue around the abdomen
- Infections
- Scars can form and affect (negatively) the function of the abdomen
- Hernias
- Bowel problems
- Difficulty with bowel function including control of bowels
- Difficulty with urination including retention or inability to urinate or inability to control urination
- Damage to the tube that carries urine from the kidneys to the bladder
- Damage to the kidneys
- Formation of kidney stones
- Nerve damage that results in sexual dysfunction
- Infertility or sterility
- Bleeding around the spinal cord resulting in temporary or permanent paralysis
- Warm or abnormal sensation in the groin or legs
Risks associated with metal implants in the spine include:
- Loosening
- Malposition
- Migration or movement of the metal implants
- Implants can break or fall apart. They can create debris
- Your body can respond to the implant with an allergic reaction or inflammatory reaction termed a foreign body response
- The tissue reaction can form tumors
- The bone can dissolve
- The implants can sink into the bone
Risks of surgery on the spine include:
- Damage to the membranes covering the spinal cord or leakage of spinal fluid
- Failure of the bone to fuse
- Infection or inflammation around the spinal cord, nerve roots or brain
- Loss of alignment of the spine or loss of reduction in the spine
- Slippage of vertebrae
- Nerve root damage
- Opening of the covering around the spinal cord
- Scar formation
- Problems with vision including blindness
- Herniation and degeneration of levels above or below the surgical area
- Abnormal growth of the nerves
- Bleeding
- Infection
- Damage or failure of the wound to heal
- Narrowing of the spinal canal causing nerve compression
Risks associated with neck surgery include:
- Difficulty swallowing
- Inability to speak
- Changes in voice
- Ear infections
- Difficulty swallowing resulting in lung infections
- Nerve Damage
- Damage to the windpipe “trachea”
- Damage to the food tube “esophagus”
- Damage to the airway
- Blockage of the airway resulting in death
- Leakage of bodily fluids including duct fluids
- Hoarseness
- Vocal cord paralysis
- Warm or abnormal sensations in the arms and legs
- Movement of bone grafts or metal plates into the spinal cord or the soft tissue around the neck
Risks of Infuse bone morphogenic protein include:
- Abnormal bone or cell growth
- Fusion at levels above or below the surgical area
- Narrowing of the spinal canal
- Fluid retention
- A foreign body reaction
- Anti-body formation
- Formation of blood clots
- The bone may break down around the region
- The tissues including the nerves may stick together due to Infuse use
- Allergic reactions
- Irritation and inflammation
- The need for further surgery
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 affected 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-fashioned 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 union 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 a 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.