Complications of Surgery for Discogenic Disease of the Spine

Abramovitz, Joel N.

doi:10.1016/s1042-3680(18)30619-3

Cited by 16 publications

(10 citation statements)

References 81 publications

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“…The frequency of complications is dependent on the underlying pathology and the complexity of the procedure [1,2,10,20]. Human error, technical failure, anatomical variations, unexpected biological responses, or any combination of these, can lead to unexpected outcomes.…”

Section: Introductionmentioning

confidence: 99%

The patient’s perspective on complications after spine surgery

Grob

Mannion

2009

Eur Spine J

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Recent years have witnessed a paradigm shift in relation to the assessment of outcome in spine surgery: multidimensional patient-centred questionnaires have superseded traditional surgeon-based ratings of outcome, and surgical registries have been developed to capitalise on the principle of ''strength in numbers.'' However, the assessment of complications has not enjoyed this same enlightened patient-centred approach. The present study investigated post-surgical complications from the patient's perspective. All German-speaking patients undergoing surgery within our Spine Center in 2005 were asked to complete the patient-orientated Core Measures Outcome Index of the SSE Spine Tango Spine Surgery Registry before and 12 months after surgery; the surgeon completed a Spine Tango surgery form. In the 12-month questionnaire, the patient was asked, ''did any complications arise as a consequence of your operation 1 year ago (e.g. problems with wound healing, paralysis, sensory disturbances, etc.)? If so, give details.'' Patients were also asked about their satisfaction with the operation and the global outcome of surgery. 1,035 patients were sent a 12-month questionnaire; 972 (94%) returned the completed questionnaire. 29% patients answered ''yes'' to the question about complications. The incidence of patient-rated complications was significantly associated with outcome/satisfaction (P \ 0.05), suggesting these complications were not trivial to the patient. The results indicate that, just like outcome, ''complications'' should be assessed from both the patient's and the surgeon's perspectives, not least to better understand the reasons accounting for dissatisfaction and a poor patient-rated outcome.

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Section: Introductionmentioning

confidence: 99%

The patient’s perspective on complications after spine surgery

Grob

Mannion

2009

Eur Spine J

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“…As complicações tardias são os pseudoaneurismas e as fístulas arteriovenosas, sendo estas as mais comuns, podendo apresentar-se com sinais e sintomas de insuficiência cardíaca, edema de uma das extremidades inferiores, sopro à ausculta abdominal 2,7,10,11 . O tratamento destas lesões dá-se com correção cirúrgica do defeito vascular iatrogenicamente estabelecido, estando a técnica empregada (rafia, enxerto de veia ou prótese) na dependência do seu local e extensão.…”

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“…As lesões vasculares ocorrem quando se ultrapassa o limite anterior do disco, constituído pelo ânulo fibroso do disco intervertebral e pelo ligamento longitudinal anterior, geralmente com instrumento como cureta ou pinça de biopsia 2,12 . Estas lesões podem ser facilitadas por defeitos do ânulo fibroso e do ligamento longitudinal anterior já existentes, bem como por alterações espondilóticas 12,13 .…”

Section: Fig 1 Corte Sagital De Ressonância Magnética De Coluna Lombunclassified

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Pseudoaneurisma de artéria ilíaca comum como complicação de cirurgia para hérnia discal lombar: relato de caso

Hanel

Madalozzo

Araújo

et al. 1999

Arq. Neuro-Psiquiatr.

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RESUMO -A cirurgia para tratamento da doença discal lombo-sacra pode cursar com complicações severas, iatrogênicas incluindo-se as neurológicas, vasculares, entéricas, ureterais e disfunção sexual podendo levar o paciente à morte dependendo da extensão da lesão. Abramovitz relata que as complicações vasculares do acesso posterior para o tratamento hérnia discal lombo-sacra ocorrem em menos de 0,1% dos casos As lesões vasculares podem manifestar-se de maneira imediata como hemorragia arterial levando a choque hipovolêmico no per ou pós-operatório imediato, devendo ser diagnosticadas e tratadas prontamente. Sinais precoces de hemorragia retroperitoneal se manifestam na vigência de lesões traumáticas, sendo os pseudoaneurismas e as fístulas arteriovenosas diagnosticados tardiamente, semanas ou mesmo após anos. Descrevemos o caso de uma paciente de 39 anos que foi submetida a tratamento cirúrgico de hérnia discal no espaço L4-L5, à direita, em outro serviço. Devido ao fato de persistirem os sintomas dolorosos, foi encaminhada ao nosso serviço. Na investigação a ressonância magnética mostrou lesão paravertebral sugestiva de abscesso. A angiografia aorto-ilíaca revelou a presença de pseudoaneurisma na artéria ilíaca comum esquerda, o qual foi reparado cirurgicamente com sucesso. Discutimos os mecanismos das lesões vasculares e as precauções para evitá-las. PALAVRAS-CHAVE: pseudoaneurisma, cirurgia de hérnia discal lombar, complicações vasculares, hemorragia. Commom iliac artery false aneurysm as complication of lumbar disc surgery: case reportABSTRACT -Surgery for discogenic disease of lumbar region is a challenging and diverse field. The significance of complications in disc surgery arises from the possibility that failure of primary treatment may lead to a permanently disable patient. The most common iatrogenic lesions in the posterior approach to lumbar disc herniation are neurologic, vascular, enteric, ureteral, and sexual dysfunction. Abramovitz reports that vascular complications of the posterior approach occur in at least 0.1% of cases. The vascular complications may present during surgery as severe bleeding leading to hypotension. The most common late complication is arteriovenous fistula followed by false aneurysms. We describe the case of a 39 year-old woman who was operated on for a lumbar disc herniation in other hospital. She came to us with a persistent pain in lumbar area. A MRI scan of lumbosacral region revealed a paravertebral lesion suggesting abscess. An angiography was performed and showed a false aneurysm of left common iliac artery, which was surgically treated successfully. We discuss the mechanisms of lesion and precautions against vascular ones during lumbar disc surgery.KEY WORDS: false aneurysm, lumbar disc surgery, vascular complications, hemorrhage.Descritas pela primeira vez em 1945 por Linton e White 1 , as complicações vasculares do acesso posterior para o tratamento cirúrgico da hérnia discal lombo-sacra são relativamente raras.

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“…Although most symptomatic cervical HIVDs are self-limited and can successfully be treated with conservative treatments1, surgery is still indicated in HIVD patients with refractory pain, persistent pain, or significant neurological consequences23. Common surgical management options for cervical HIVD are an anterior cervical discectomy and fusion (ACDF), a posterior foraminotomy, and total disc replacement.4 Surgery for a cervical HIVD usually provides a high success rate of relieving radicular pain and carries a low risk for complications by an experienced neurosurgeon.…”

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confidence: 99%

Increased Risk for Adhesive Capsulitis of the Shoulder following Cervical Disc Surgery

Kang

Lin

Tsai

et al. 2016

Sci Rep

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Shoulder problems are common in patients with a cervical herniated intervertebral disc (HIVD). This study aimed to explore the incidence and risk of shoulder capsulitis/tendonitis following cervical HIVD surgery. We used data from the Taiwan “Longitudinal Health Insurance Database”. We identified all patients who were hospitalized with a diagnosis of displacement of a cervical HIVD and who underwent cervical surgery (n = 1625). We selected 8125 patients who received cervical HIVD conservative therapy only as the comparison group matched with study patients. We individually tracked these sampled patients for 6 months to identify all patients who received a diagnosis of shoulder tendonitis/capsulitis. We found that incidence rates of shoulder tendonitis/capsulitis during the 6-month follow-up period were 3.69 (95% CI: 2.49~5.27) per 100 person-years for the study group and 2.33 (95% CI: 1.89~2.86) per 100 person-years for the comparison group. Cox proportional hazard regressions showed that the adjusted hazard ratio for shoulder tendonitis/capsulitis among patients who underwent cervical disc surgery was 1.66 (95% CI = 1.09~2.53) when compared to comparison group. We concluded that patients who underwent surgery for a cervical HIVD had a significantly higher risk of developing shoulder capsulitis/tendonitis in 6 months follow-up compared to patients who received cervical HIVD conservative therapy only.

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Complications of Surgery for Discogenic Disease of the Spine

Cited by 16 publications

References 81 publications

The patient’s perspective on complications after spine surgery

The patient’s perspective on complications after spine surgery

Pseudoaneurisma de artéria ilíaca comum como complicação de cirurgia para hérnia discal lombar: relato de caso

Increased Risk for Adhesive Capsulitis of the Shoulder following Cervical Disc Surgery

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