Nerve, Fusion, and Implant Complications of Spine Surgery

A spine surgeon doesn’t recommend a surgical procedure unless it offers a significant benefit—such as relief from low back and/or leg pain (eg, discectomy) or treatment of spinal deformity (eg, scoliosis). Along with the discussion about the potential benefits of a surgical procedure, your surgeon will explain your potential risk/s for a complication—such as nerve damage, spinal fusion that doesn’t heal properly, or a spinal implant problem. Some patients have one or more coexisting medical conditions that may increase their risk for a complication (eg, tobacco user, osteoporosis). The good news is, the incidence of complications are relative rare.

Your spine surgeon will explain the potential benefits and complications related to your overall health, and the particular type of spine surgery recommended. Understanding the benefits and risks can help you to make informed choices about your medical care.
Female doctor in consultation with an elderly patientUnderstanding the benefits and risks can help you to make informed choices about your medical care. Photo Source:

Preventing Nerve Damage

Spinal surgery involves working carefully around fragile nerve structures, such as nerve roots and the spinal cord. It is possible to bruise or cut a nerve during a surgical procedure, although modern operative safeguards are employed to help prevent this from happening.

  • Surgical microscopes magnify and illuminate the surgeon’s view of the operative field.
  • Advanced imaging techniques enable surgeons to preplan surgery using high definition three dimensional imaging of the patient’s anatomy.
  • During surgery, intraoperative imaging and visualization of the surgical field in detail provide the surgeon and his/her team with accurate positioning of instruments and implant.

Ask your surgeon precisely what steps his/her team takes to prevent nerve or spinal cord injury.

About Neural Injury: Spinal Nerves and Spinal Cord

An injured nerve may cause pain, weakness, and/or numbness, whereas spinal cord injury may cause paralysis. Damage to the spinal cord can cause paralysis in certain areas of the body depending on where the cord is bruised or injured.

Sexual Dysfunction

The spinal cord and spinal nerves carry the nerve signals that enable your body to function and feel sensation. If a nerve is damaged that connects to the pelvic region, it could lead to sexual dysfunction.

Delayed Union or Nonunion

Your surgeon will tell you how long it should take for your fusion to heal. In some cases, fusion may heal at a slower rate than expected—this is called a delayed union. But, some fusions do not heal properly. This complication is known as nonunion.

Spinal Implant Problems

Instrumentation such as rods, plates, screws, and/or interbody devices may be implanted for different reasons, such as to restore disc space between two vertebral bodies or to stabilize the spine. Although rare—spinal instrumentation, which your doctor may refer to as fixation, may become damaged, break, or move from its original implanted position. If this occurs, a second operation may be needed to remove and/or replace the implants.

Transitional Syndrome/Adjacent Segment Disease

Transitional syndrome is also known as adjacent segment disease. It may develop above and/or below one or more fused and/or instrumented levels of the spine.

The spine could be compared to a chain of links that move and work together. However, when one or more links are removed and/or changed (eg, spinal fusion), the way the chain moves/works is changed. Over time, the adjacent links may wear or distribute more stress to the adjoining link. The stress may lead to micro-motion or a minor alteration in the dynamics of the spinal levels above and below the fusion that causes pain.


An unsuccessful fusion is called pseudoarthrosis. This may develop if micro-motion occurs between two vertebrae that should be fused together as a solid. The condition causes pain. To treat pseudoarthrosis, a second surgery may be necessary. In some circumstances, a bone healing stimulator may be implanted temporarily to stimulate fusion and bone healing.

Spine Surgery: The Benefits Outweigh the Risks

With modern advances in spine surgery, including minimally invasive techniques and the ability to have your procedure performed in an outpatient spine center (ambulatory surgery center), most patients report less pain and improved quality of life after spine surgery. While the complications outlined in this article are rare, it’s still important you understand the potential risks of your back or neck procedure. Talk to your surgeon before you undergo spine surgery to fully understand your potential benefits and risks.

Updated on: 04/19/19
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Spine Surgery Risks and Potential Complications
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Spine Surgery Risks and Potential Complications

Complications of spine surgery to treat neck or back pain are often similar to other operations, except spinal surgery may involve greater risk depending on how it is performed (open or minimally invasive) and if spinal instrumentation and fusion are involved.
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