Bleeding after Back Surgery Is Rare but Dangerous

Bleeding as a complication after lumbar spine surgery doesn't happen very often. When it does, it's an emergency.

The large blood vessels including the aorta and its branches lie in front of and very close to the column of vertebral bones. They don't move much and can't be pulled out of the way very easily. When the patient is operated on in the face-down position, the spine presses closer to these blood vessels.

The blood vessels can be damaged easily. Bleeding can result in very low blood pressure early after the operation. This same problem can also occur up to nine years after the operation.

The treatment is immediate surgery to repair the damaged blood vessel. The surgeon may be able to stitch the blood vessel closed. If not, then a Dacron graft is used. This graft is made of synthetic materials tightly woven together in a tube or blood vessel-like shape. The graft is used to repair or replace the injured vessel.

Occasionally the surgeon opens the patient up to do the repair and doesn't find a bleeding problem to explain the signs and symptoms. This doesn't happen very often, but it is an accepted practice. If the diagnosis is delayed too long, the patient can develop much worse problems. The author of this report advises surgeons to take the time to make a calm and deliberate treatment choice.

Reference: 

Hakan Bingol, MD, et al. Vascular Complications Related to Lumbar Disc Surgery. In Journal of Neurosurgery: Spine. March 2004. Vol. 100. No. 3. Pp. 249-253.

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