Peri-operational Complications and Prevention of Posterior Surgery for Lumbar Degenerative Diseases (Cause Analy-sis and Prevention Strategies)

HE Qing; ZHANG Chao; RUAN Di-ke; WEN Tian-yong

doi:10.3969/j.issn.1002-3429.2015.01.010

Abstract：Objective To summarize and evaluate the cause and preventions of peri-operational complications associ-ated with surgical treatment for lumbar degenerative diseases. Methods A total of 784 patients with degenerative diseases of lumbar spine undergoing posterior surgical treatment between October 2005 and October 2011 were analyzed retrospectively. Results 80 cases (10. 2%) experienced peri-operation complications in 784 patients. The most common complication was temporary postsurgical sciatica (4. 6%, 36 patients), which was relieved after symptomatic treatment. There were 31 patients (4. 0%) with cerebrospinal fluid leakage, of the 27 patients with dural tears during the operations, 24 had the tear repair im-mediately, and 3 were covered by adipose tissue. 4 patients had CSF leakage without obvious dural tears during the surgery. Wound drainage was kept for 12 days post surgery or less than 50 ml of 24-hour-drainage for the treatment of CSF leakage. There were 9 patients (1. 1%) with neurological deficit after operation, 7 patients recovered completely in 3 months post sur-gery. Only one had numbness of dorsal foot and one had foot drop. Deep wound infections occurred in 4 patients (0. 5%), 2 of these patients recovered after debridement and systemic antibiotics treatments without removal of spinal instrumentation. One patient died of secondary multiple organs failure after debridement and implants extraction. One patient was successfully trea-ted with systemic antibiotics therapy only. Conclusion Comprehensive knowledge anatomy of the lumbar spine, appropriate surgical technique and intense careful skills during operation are critical in preventing, detecting, and managing complications in low back surgeries.