Spinal surgery is intricate and delicate surgery, with potential risks and complications.

This includes but is not limited to:

Anaesthetic/Positioning related complications

Nervous tissue injury

Whilst the risk is extremely low, there are meticulous steps undertaken to mitigate the risks. These include:

  • “Circuit testing” of the spinal cord and nerves during the operation- neurophysiological monitoring
  • Scrupulous attention to optimising cardiovascular status including blood pressure
  • Meticulous positioning
  • Intraoperative illumination and magnification.

Dural Injury

A durotomy is defined as a surgical opening of fluid sac around the spinal nerves. This can be deliberate ( i.e. in the case of pathology within the dural sac or incidental. The rate of incidental durotomy in the literature ranges for 1%-13% surgeries, with the rates being higher in revision surgeries. There is no evidence in the literature that an incidental durotomy results in an inferior long-term clinical outcome.

Infections

These can be early or late, superficial (adjacent to skin) or deep. The rate of wound infection following surgery of the spine is reported to be between 0.7-3% in the literature. Steps undertaken to reduce infection include: antibiotic therapy during and after the operation and meticulous attention to medical conditions.

Non Unioun (Pseudoarthrosis)

Non union is defined as a failure of bone forming between contagious vertebrae. There is a wide variance in the rates of non-union reported in the scientific literature, ranging from 10-85% across various scientific studies. Whilst all care is taken to optimise the surgical milieu, it is imperative that you maintain a balance nutritious diet, undergo activity within the recommended boundaries and do not smoke (smoking increases the non-union rates by a factor of 4).

Implant Failure/RevisIon

The main reasons for implant failure/revision include: biological reasons (i.e. osteoporosis) and adjacent segment pathology.