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Spine Surgery pp 673-695 | Cite as

Nonspinal Complications

  • Sandro M. KriegEmail author
Chapter

Abstract

The spectrum and complexity of spinal procedures vary widely and so does the rate of complications. While we all are well trained in the management of spinal complications, such as dural tears, secondary hemorrhage, or wound infections, many of us are less experienced and trained in the management of the more infrequent non-spinal complications of spine surgeries. Arterial, venous, esophageal or bowel injury, hernias, ileus, sympathetic dysfunction or even vascular compression along with intraoperative hypoperfusion are complications many spine surgeon only know from courses or textbooks. If they occur, however, we all should be prepared to be able to provide the best management of this unplanned situation. Although quite rare for smaller spinal procedures, such as microdiscectomy, these complications increase in frequency along with the complexity and size of the approach and procedure. While for microdiscectomy these incidents are mostly case reports or such a rare complication, some ALIF series report vascular complications in up to 20% of cases. Vice versa, the risk of misdiagnosing leading to no or improper management can be higher in smaller procedures since the surgeons is not prepared for it. Diagnosis can be delayed, sequalae become more severe, and consequences for the patients can get worse. For instance, the two largest analysis of intraoperative arterial injury during microdiscectomy reported an associated mortality rate of 38% and 61%.

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryKlinikum rechts der Isar, Technische Universität MünchenMunichGermany

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