With any surgery, there is the risk of complications. When surgery is done near the spine and spinal cord, these complications (if they occur) can be very serious. Complications could involve subsequent pain and impairment and the need for additional surgery. You should discuss the complications associated with surgery with your doctor before surgery. The list of complications provided here is not intended to be a complete list of complications and is not a substitute for discussing the risks of surgery with your doctor. Only your doctor can evaluate your condition and inform you of the risks of any medical treatment he or she may recommend.
The vast majority of surgical procedures require that some type of anesthesia be done before the surgery. This is so that you will not feel, or be aware of the procedure. The simplest form of anesthesia is local anesthesia. Local anesthesia is done by injecting a medication (usually Novocain) around the area of the surgical procedure that “numbs” the skin and surrounding tissue. The most complex form of anesthesia is general anesthesia. General anesthesia is where you go completely to sleep during the surgical procedure. Medications are given by intravenous lines (IVs) to put you to sleep. Special machines breathe for you, monitor your vital signs, and alert the anesthesiologist to any problems while you are asleep. You are kept asleep during the operation by a combination of medications given through the IV line and “anesthetic gases” that you inhale through special machines controlling your breathing. Most spinal operations require general anesthesia. A very small number of patients may have problems with general anesthesia. These can be problems due to reactions to the drugs used, problems arising from your other medical problems, and problems due to the anesthesia. Be sure to discuss these complications with your anesthesiologist.
When blood clots form inside the veins of the legs, it is referred to as Deep Venous Thrombosis (DVT). This is a common problem following many types of surgical procedures. It is true that these blood clots can also form in certain individuals who have not undergone any recent surgery. These blood clots form in the large veins of the calf and may continue to grow and extend up into the veins of the thigh, and in some cases into the veins of the pelvis.
The risk of developing DVT is much higher following surgery involving the pelvis, and surgery involving the lower extremities. There are many reasons that the risk of DVT is higher after surgery. First, the body is trying to stop the bleeding associated with surgery, and the body’s clotting mechanism is very hyperactive during this period. In addition, injury to blood vessels around the surgical site, from normal tugging and pulling during surgery, can set off the clotting process. Finally, blood that does not move well sits in the veins and becomes stagnant. Blood that sits too long in one spot usually begins to clot.
Why do we worry about blood clots? Blood clots that fill the deep veins of the legs stop the normal flow of venous blood from the legs back to the heart. This causes swelling and pain in the affected leg. If the blood clot inside the vein does not dissolve, the swelling may become chronic and can cause discomfort and swelling permanently. While this may seem bad enough, the real danger that a blood clot poses is much more serious. If a portion of the forming blood clot breaks free inside the veins of the leg, it may travel through the veins to the lung, where it can lodge itself in the tiny vessels of the lung. This cuts off the blood supply to the portion of the lung that is blocked. The portion of the lung that is blocked cannot survive and may collapse. This is called a pulmonary embolism. If a pulmonary embolism is large enough, and the portion of the lung that collapses is large enough – it may cause death. With this in mind, it is easy to see why prevention of DVT is a serious matter.
Reducing the risk of developing DVT is a high priority following any type of surgery. Things that can be done to reduce the risk of developing DVT fall into two categories: