Lumbar Spine Surgery Can Be Risky Business

The number of lumbar (lower) spine operations is increasing--and they are increasingly complex. As with any type of surgery, there can be complications. Neurologic complications are an uncommon but very serious potential side effect of lumbar spine surgery. The spinal cord and the spinal nerve roots are much more fragile than nerves away from the spine. This means that spine surgeons need to be especially careful during procedures. It also means that post-surgical swelling and other fairly common surgical complications can have major consequences. 

These authors summarized the neurological problems that can happen after spine surgery, as well as precautions to help avoid or recognize problems. Neurological problems can develop during surgery, shortly after surgery, or more than two weeks after surgery. Different problems develop at different rates. Problems can stem from many causes, including:

• anesthesia


• surgical techniques and tools


• patient positioning


• postoperative swelling


• changes in spine alignment


• hardware placement


• bone graft sites


• previous surgeries


• abnormal anatomy

The authors stress throughout the article that surgical skill and pre-operative planning are the most important ways to avoid problems. Close and careful monitoring after surgery can also help doctors identify problems early. Early identification can sometimes prevent the development of major problems. However, some problems are impossible to predict or avoid. The delicate nature of the spinal cord and the difficulty of the procedures mean that lumbar spine surgery will always be a somewhat risky business.