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YOU are here : Home > Spinecare Topics > Options for Spine Treatments > Benefits and Risks of Back Surgery
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Benefits and Risks of Back Surgery
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Benefits and Risks of Back Surgery
Bleeding
Spine surgery like any other surgery is associated with the risk of bleeding during and after the procedure. Bleeding can occur wherever there are blood vessels. In the case of spine surgery, bleeding can occur within the spine or outside the spine. It can occur anywhere along the surgical path. Because of the complexity of the spine and its blood supply, spine surgery poses a unique risk for unexpected bleeding. If surgical access through the abdomen is required the attending surgeon must physically move the large aorta and other large blood vessels out of the way. Excessive bleeding can lead to a hematoma, which is a collection of blood, which forms a mass. A hematoma can put pressure on adjacent tissues. Bleeding into the spinal cord can lead to permanent damage (hemorrhagic infarct) of the cord. Individuals with a blood clotting abnormality are more likely to have bleeding complications.
Dural Tear
Spine surgery can result in a cut or tear of the pain sensitive lining around the spinal cord and spinal nerves. The dura (dura mater) is a membranous sac that surrounds the spinal cord and the spinal nerves. If a tear is recognized during surgery it is usually easily repaired without residual complications. If a dural tear occurs and is not recognized during surgery it may not heal adequately and may result in a spinal fluid leak. The loss of spinal fluid causes a drop in spinal fluid pressure around the spinal cord and the brain resulting in a severe headache. This type of headache is often referred to as a “spinal headache.� The presence of a dural tear also increases the risk for developing an infection involving the cerebrospinal fluid and the lining around the spinal cord and spinal nerves (spinal meningitis). If the dural leak does not quickly heal, additional procedures will be necessary. A blood patch is performed for small puncture repair by injecting your own blood into the epidural space to promote closure of the hole. A re-operation may be required to adequately repair a scalpel induced dural tear.
Lung Problems
It is important that the lungs work properly during and after surgery. Proper lung function is required to get oxygen into the blood and to the all of the tissues and systems of the body. The success of spine surgery is dependent upon good lung (pulmonary) function. Oxygen is required for tissue to survive and heal. Reduced air movement through the lungs increases the risk for developing a bacterial and/or viral pulmonary infection after surgery.
There are several reasons why the lungs may not work like they should during or after spine surgery. While sedated under general anesthesia, lung function is typically reduced leading to less air and oxygen movement through the lungs. Lying on the back on the operating table or in bed can also contribute to reduced lung function. Back pain can limit chest movement reducing lung function. Medication used for pain management can also suppress breathing. The more sedative the medication the greater likelihood of reduced lung function.
There are several things that can be done after surgery to try to keep the lungs working at an optimum level. The patient will be encouraged to take frequent deep breaths. They will also be asked to periodically cough which creates positive pressure in the lungs thus helping to move air into more remote areas of the lung. These simple activities can significantly help reduce the risk for infection and partial lung collapse (ateleotosis). You will be encouraged to sit up and to get moving as soon as possible.
Spine surgery like any other surgery is associated with the risk of bleeding during and after the procedure. Bleeding can occur wherever there are blood vessels. In the case of spine surgery, bleeding can occur within the spine or outside the spine. It can occur anywhere along the surgical path. Because of the complexity of the spine and its blood supply, spine surgery poses a unique risk for unexpected bleeding. If surgical access through the abdomen is required the attending surgeon must physically move the large aorta and other large blood vessels out of the way. Excessive bleeding can lead to a hematoma, which is a collection of blood, which forms a mass. A hematoma can put pressure on adjacent tissues. Bleeding into the spinal cord can lead to permanent damage (hemorrhagic infarct) of the cord. Individuals with a blood clotting abnormality are more likely to have bleeding complications.
Dural Tear
Spine surgery can result in a cut or tear of the pain sensitive lining around the spinal cord and spinal nerves. The dura (dura mater) is a membranous sac that surrounds the spinal cord and the spinal nerves. If a tear is recognized during surgery it is usually easily repaired without residual complications. If a dural tear occurs and is not recognized during surgery it may not heal adequately and may result in a spinal fluid leak. The loss of spinal fluid causes a drop in spinal fluid pressure around the spinal cord and the brain resulting in a severe headache. This type of headache is often referred to as a “spinal headache.� The presence of a dural tear also increases the risk for developing an infection involving the cerebrospinal fluid and the lining around the spinal cord and spinal nerves (spinal meningitis). If the dural leak does not quickly heal, additional procedures will be necessary. A blood patch is performed for small puncture repair by injecting your own blood into the epidural space to promote closure of the hole. A re-operation may be required to adequately repair a scalpel induced dural tear.
Lung Problems
It is important that the lungs work properly during and after surgery. Proper lung function is required to get oxygen into the blood and to the all of the tissues and systems of the body. The success of spine surgery is dependent upon good lung (pulmonary) function. Oxygen is required for tissue to survive and heal. Reduced air movement through the lungs increases the risk for developing a bacterial and/or viral pulmonary infection after surgery.
There are several reasons why the lungs may not work like they should during or after spine surgery. While sedated under general anesthesia, lung function is typically reduced leading to less air and oxygen movement through the lungs. Lying on the back on the operating table or in bed can also contribute to reduced lung function. Back pain can limit chest movement reducing lung function. Medication used for pain management can also suppress breathing. The more sedative the medication the greater likelihood of reduced lung function.
There are several things that can be done after surgery to try to keep the lungs working at an optimum level. The patient will be encouraged to take frequent deep breaths. They will also be asked to periodically cough which creates positive pressure in the lungs thus helping to move air into more remote areas of the lung. These simple activities can significantly help reduce the risk for infection and partial lung collapse (ateleotosis). You will be encouraged to sit up and to get moving as soon as possible.
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