Spine Surgery Risks and Potential Complications

Surgery of any type has the potential for complications, and spine surgery is no different

Surgery of any type has the potential for complications, and spine surgery is no different. If you have a scheduled spine surgery, one of your first questions is likely about the risks of your procedure. While your surgeon will explain the possible risks of your specific back or neck treatment, this article describes potential general complications of spine surgery: anesthesia, blood clots, infection, lung problems, and persistent pain.
Mature male doctor looking at clipboard and looking confused while standing against grey backgroundMany factors can affect your risk for a surgical complication, such as age, coexisting medical conditions, and smoking. But, fortunately, the likelihood that any of the complications below will occur during or after your surgery may be rare. Your surgeon will explain your risk for a complication depending on many factors, including your overall health and previous surgical experience.

If you want to learn about more specific spine surgery risks, read Nerve, Fusion, and Implant Complications of Spine Surgery.

Anesthesia Risks
Spine surgeries are performed under general anesthesia. You will be given medication through an intravenous (IV) line to put you to sleep, so you won’t feel pain during the procedure. Risks from anesthesia are rare but serious. These risks include heart attack, stroke, brain damage, and death. These complications may be caused by drug reactions or problems stemming from other medical conditions. Tell your surgeon and anesthesiologist if you, or a family member has had an adverse reaction to anesthesia, and if you use tobacco and/or alcohol.

Blood Clots
Patients undergoing surgical procedures, especially surgery involving the pelvis or the lower extremities, are at risk of developing blood clots inside the veins in their legs (a condition known as deep venous thrombosis or DVT). After surgery, the body’s clotting mechanism is very active because it is trying to stop the bleeding caused by the surgery. Injury to the blood vessels around the surgical site can also cause clotting.

Clots can form in the large veins in the calf, and they may continue to grow and extend up into the veins in the thigh. In some cases, they can reach the veins of the pelvis. If part of the clot breaks free, it can travel through the veins to the lung(s) and cut off blood supply to the part of the lung that is blocked. This blood clot in the lung is called a pulmonary embolism, and it is potentially life-threatening.

To reduce the risk of DVT, your doctor will recommend you move as soon as possible after surgery so your blood circulates. If you need to stay in bed, you can pump your feet up and down (as if pushing on the gas pedal) to get blood moving back to your heart. You may also be given special stockings called pulsatile stockings, which wrap around each calf and thigh. A pump inflates the stockings every few minutes, squeezing the veins in the legs and pushing blood back to the heart. Another type of stocking, called TED hose, squeezes the veins of the legs shut. This reduces the amount of blood that pools in the veins of the leg, reducing the risk of blood clots.

Your doctor may also prescribe you medication to reduce the risk of blood clots. These blood-thinning drugs include aspirin, heparin, enoxaparin, or warfarin.

Blood clots can occur during the first few weeks after surgery. Warning signs of a possible clod clot include:

  • Swelling in the calf, ankle, or foot
  • Tenderness or redness, which may extend above or below the knee
  • Pain in the calf

Warning signs of a pulmonary embolism are sudden chest pain, shortness of breath, and cough. While hospitalized, medical staff will carefully monitor you for DVT and symptoms of pulmonary embolism (among other potential complications). However, even if hospitalized you experience these symptoms, alert the nurse immediately. If you’ve been discharged home and experience symptoms, call 911 immediately.

The risk of infection following spinal surgery is small in most patients. You will receive antibiotics immediately before surgery to reduce your risk of infection.

If an infection does develop, it may be superficial (in the skin incision only), or it can spread deeper to the areas around the spinal cord and vertebrae.

Signs of an infection can include:

  • a red, hot, and swollen wound
  • increased pain
  • fever, sometimes accompanied by chills
  • clear liquid or yellow pus oozing from the incision
  • a foul-smelling odor at the wound site

If you experience any of these symptoms, contact your doctor immediately or go to the emergency room. A superficial wound infection can usually be treated with antibiotics, but deeper wound infections may require additional surgery to drain the infection. In some cases, the surgeon may need to remove any bone graft and/or spinal devices placed during the spine surgery.

Lung Problems
Your lungs can be affected by anesthesia, lack of activity and pain medication following surgery. If your lungs are not working properly after surgery, it can lead to pneumonia.

To avoid lung complications, your doctor will ask you to take frequent deep breaths and cough often. Getting out of bed, even to sit upright in a chair, helps your lungs function better. You may be given a device called a spirometer, which measures how hard you are breathing and helps improve your deep breathing.

Persistent Pain
In some cases, spine surgery does not completely reduce or resolve the pain—it may increase your pain. While some pain after surgery is normal, you should talk to your doctor about persistent pain that lasts after your surgery to discuss your options.

Spine Surgery Risks Are Rare, But Be Informed
While the spine surgery risks outlined in this article are rare, it’s important you understand any potential complications that could occur during or after your treatment. Ask your doctor about any risks associated with your specific back or neck procedure, including ways you can help prevent these complications.

Updated on: 04/13/17
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