Spinal surgery is safer than it has ever been. Advances in technology have allowed for closer monitoring of nerve function before, during, and after procedures. Additionally, the use of less invasive surgical techniques helps minimize the risk of infection and cutting-edge materials make for more reliable instrumentation.
Nonetheless, every surgery from the least invasive to the most complicated carries the risk of complications. Understanding the possible spinal surgery complications is a good way to prepare yourself even more for your upcoming spinal surgery.
Infection
Your body is made up of a multitude of various systems. Some of these are what are known as “closed systems”. This means that your circulatory system, dura mater (the tough, fibrous sac that surrounds your brain and spinal cord), and nervous system are each self-contained. Even your skin provides a barrier to the outside world, protecting muscles, bones and organs from external influences.
When one of these systems must be breached for surgery, it raises the possibility of infection from outside sources.
Most surgical site infections (SSIs) occur when a foreign substance or pathogen enters into the incision site. This can happen due to a number of reasons; however a distinct, identifiable cause is often not recognized. Unfortunately, whenever the skin is opened the potential for an infection exists.
Because this is a valid concern, it is doubly important that you choose a fully-accredited New Jersey surgical center or hospital with a track record for low infection rates and extremely high standards of sterility.
Resolving the problem
The best way to prevent infection is to eliminate, as much as possible, potential pathogens or contaminants that might get into the surgical area. Post-surgical care should always be carried out by someone that has thoroughly washed their hands and at certain times wears protective garments. Regularly changing dressings may be required and should be performed under clean conditions.
Unfortunately, infections can still occur, regardless of how many precautions are taken. In these instances, identifying the offending organism is required in order to administer an effective antibiotic treatment. Initially this is attempted with oral medications, however if the infection persists, intravenous antibiotics or surgical removal of the infected tissues may be required.
Anesthesia
Anesthesia is safer than ever, with better drugs and more advanced monitoring equipment. There can still be complications associated with anesthesia, however, so it’s important to understand how these issues occur.
There are two main types of anesthetic: local and general. Local anesthetic involves numbing the area that is to be operated on. It is typically used for skin surgeries or other small procedures that don’t affect a large area of the body or go beyond skin and muscle.
The other type of anesthesia is known as general. General anesthesia is used in instances when it’s best if the patient is completely asleep for the duration of the surgery. It uses a carefully balanced combination of IV drugs and gases that help keep you in a sleep state. It is managed by a doctor known as an anesthesiologist. The majority of spine surgeries are done under general anesthetic.
Complications with anesthesia are rare but can include reactions to the anesthetic drugs, pre-existing medical issues (such as kidney or liver insufficiency, making it more difficult to filter the drugs from your system), pneumonia, or issues with the anesthetic process itself.
Resolving the problem
You may not know beforehand if you will have a reaction to certain drugs. It can, however, be minimized if you give your doctor a full medical history. Are you allergic to eggs? Have you ever had a seizure? Do you have a history of opioid use? Do you smoke? All of this information will help your doctors determine the best medications to use so you can avoid spinal surgery complications.
In the instance that an anesthetic issue occurs, you may be given drugs to counteract the ones causing the problems. If your body is not metabolizing and clearing the drugs properly, you may be given IV fluids and other therapies to help clear out the excess drug.
Overall, it’s essential that you have an experienced anesthesiologist that is armed with all of the right information so that your chances of experiencing an anesthetic problem are minimized.
Blood Clots
Blood clots (also known as deep vein thrombosis or DVT) can occur with any surgery but especially those performed under general anesthesia. The development of a post-surgical blood clot in the large vein of your leg is more likely to happen if you have undergone surgery a lengthy procedure. While not common, clots, in general, are not exclusive to surgery.
Because most spinal surgeries are performed in a less invasive manner, the trauma to tissues and subsequent clotting reactions (it’s normal for the body to develop clots if it detects a threat that may lead to excess bleeding, such as a large incision or the normal pulling on veins during some surgeries) tend to be less likely.
The biggest risk from blood clots is having them break loose and migrate to your lungs, causing what is called a pulmonary embolism. Pulmonary embolisms can be incredibly serious or even fatal.
If you have a clotting condition, be sure your doctor knows about it prior to surgery. Even if you don’t, it is helpful to have a discussion regarding your likelihood of developing clots during or after your surgery.
Resolving the problem
While prevention of blood clots is key (starting physical therapy as soon as possible, wearing compression garments or taking blood thinners if clotting is a known issue, etc.), they can still occur. If you’re concerned about developing a DVT, it might help to understand the steps that are taken to treat them.
In many cases, blood clots can be treated through the use of blood thinners such as coumadin or warfarin, which slowly “wear away” and dissolve the clots.
Other treatments may include drugs known as “clot busters”. These medications quickly break up clots and allow them to be reabsorbed into the bloodstream. Clot buster drugs are often one of the last options used as they can cause severe bleeding.
Clot filters are utilized if you cannot take blood thinners or other drugs for clotting. They are placed in the vein and catch any portions of the clot that may break loose, preventing them from traveling to and lodging in the lungs.
Spinal Cord or Nerve Damage
Specialized monitoring equipment has helped to greatly reduce the possibility of your spinal cord or nerves becoming damaged during spinal surgery. Despite this, there is a small chance one of these structures might be damaged during the course of your surgery. Most surgery-related damage is minor and can be treated.
Resolving the problem
Nerve damage can cause pain, numbness or dysfunction in the area of the body served by the damaged nerve. A number of treatments are used to treat this type of injury and found to be effective.
Drugs such as corticosteroids can relieve the inflammation at the site of the damaged nerve tissue. This allows the tissue to heal without the influence of an inflammatory response. Additionally, pain relievers can help alleviate some of the symptoms, allowing you to move more freely while the nerve heals.
In cases of more severe damage, unresponsive to medications, treatments such as neurostimulators may be used, or even additional surgery. If you are concerned about nerve damage, discuss the prevalence of this problem as a complication of your particular type of spine surgery.
Understanding the potential spinal surgery complications and their treatments can help you become more prepared for your spinal surgery. Luckily, there are many highly qualified neurosurgeons in New Jersey that can help explain the risks associated with spinal surgery.
