What are the possible complications of surgery to treat lumbar disc disease?

Updated: Sep 25, 2018
  • Author: Kamran Sahrakar, MD, FACS; Chief Editor: Brian H Kopell, MD  more...
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Answer

The overall complication rate is 2-4% for the surgery.

Despite endless reports of misadventures, surgeons still sometimes operate on the wrong level. Therefore, reliance on intraoperative radiographic confirmation of the intended level is strongly encouraged.

Bleeding intraoperatively can be copious and is almost invariably due to malpositioning. Engorged venous epidural channels can make the operation more difficult and far more dangerous. Very rarely, the anterior annulus is violated and a retroperitoneal vessel is injured. Awareness of this complication is essential. Should this occur, the back is closed while a vascular surgeon prepares to repair the vessel via laparotomy.

Infections, usually skin infections, can occur. The authors' protocol is to administer one dose of a preoperative antibiotic within one hour of surgery. Very rarely, postoperative discitis can cripple a patient who is recovering. Suspect discitis in the setting of an increasing sedimentation rate, fevers, severe localized pain, and recurrent symptoms.

Increased neurologic deficit is usually mild and is due to excessive retraction of the root. If a nerve root is mistaken for a disc herniation and is removed, the resultant injury can be severe. If possible, identify the root and disc in the same field. On occasion, a conjoined root can add significant technical complexity to the case.


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