Are There Risks to a Spinal Stenosis Surgery?

Like any other surgical procedure, spinal stenosis surgery has its own risks and possible complications. However, if performed correctly by professional medical staff, the possibility of any complication after the surgery is low.

The potential risks and possible complications following a spinal stenosis surgery may include:

1. Nerve Root Damage

Nerve root damage is a rare complication that occurs during a spinal stenosis surgery. Because modern surgical techniques enable the doctor to avoid damaging the major nerves, this complication is rare. However, when in the hands of an inexperienced surgeon, the risk of nerve damage becomes more significant and can have terrible consequences.

During a spinal stenosis surgery, for example, the surgeon operates around crucial spinal nerves that control vital body functions. Damage to any of these nerves could lead to paralysis and other complications, which is why it is always best to have your surgery performed by an experienced surgeon.

2. Cerebrospinal Fluid Leak

This complication occurs after the dural sac is breached, leading to a leak of the fluid. However, the patient only needs to lie down for about 24 hours to allow the leak to seal. Therefore, the complications due to a leak are limited.

3. Infections

The skin is the body's largest organ. It may often be disregarded, but it plays an important role in keeping out bacteria and viruses that may cause an infection to the body's internal organs.

During a spinal stenosis surgery, an incision is usually made, which can be as small as 1 inch in the case of a minimally invasive surgery. However, it can also be larger if it is an open surgery. Infections are common at the site where the incision was made, and they are referred to as surgical site infections (SSIs). However, they can also affect other areas of the body. SSIs can be classified as:

• Superficial Incisional SSI: Occurs on the skin where the surgeon made an incision. These infections are recognized from the formation of pus around the surgical site.

• Deep Incisional SSI: Occurs in the tissues below the skin and the surrounding muscles of the surgical site. These infections also produce pus beneath the skin, which may cause the wound to reopen.

• Organ SSI: Caused by an infection that can get into the bloodstream and spread to other parts of the body, infecting organs and tissues farther away from the surgical site.

When a surgical site is infected, there will be signs of infection such as fever and warmth, as well as tenderness or swelling at the surgical site.

There is no way of completely avoiding an infection, even if the procedure is performed in a sterile environment. However, most bacteria enter the body after the patient is out of the operating room. The hospital is one of the locations rife with bacteria because most illnesses are treated there, and by staying in the hospital after surgery, the patient is exposed to many of these germs.

Since it is impossible to prevent infection, possible infections are treated preemptively using antibiotics. The patient will be given antibiotics before, during, and after the surgery. Antibiotics are often given intravenously and then prescribed orally after being discharged. These are usually sufficient in preventing any infections that may arise.

In addition, the surgical site where the incision was made is regularly cleaned using antiseptic solutions to keep the area free from bacteria, and the bandages are regularly changed to ensure bacteria in the bandages do not enter the surgical site. With proper care and medication, the risk of SSI is very small at about 1-3 percent, which is a great improvement compared to the 19th century, when many patients died after surgery just from infections.

4. Pain

You can always expect to feel pain after the surgery because incisions made during surgery expose nerve endings and cause damage to muscles and tissues. Minimally invasive surgery will always have lesser pain because there are only a few exposed nerve endings or damaged tissues. Open surgery, on the other hand, will always lead to a lot of pain, but you won’t even notice it because pain medications will always be intravenously supplied after surgery.

Even after being discharged, you may still have to take oral pain medications until your body heals. Physical activity and proper care of the surgical site will help you heal faster.

5. Bleeding

Cutting through major blood vessels can lead to excessive bleeding, but this can be easily avoided by choosing an experienced surgeon. Even so, you should still expect some bleeding around the surgical site, but this is not a cause for alarm because the body will heal if cared for properly.

6. Blood Clots

The formation of blood clots is rare, but it is most common among smokers and overweight patients. By lying in the hospital bed with minimal movement, clots may form in the legs, and while not directly dangerous, they can pose fatal consequences if they travel up to the lungs or heart.

When there is a clot, you will notice that the affected leg will become swollen causing pain in the calf. If left unattended, the clot moves to the lungs and causes pulmonary embolism, which causes chest pain and shortness of breath.

7. Pseudoarthrosis

After surgery on the spinal vertebrae, these bones are supposed to heal over time and resume normal functioning. However, sometimes, the body does not recognize that the bone operated on is a part of the other bones, and it does not unite them together. This leaves that bone moving freely and causing pain to the patient. To correct this condition, another surgery is required to join the bones together. It is common for this to happen in patients who are smokers.

8. Weakness and Muscle Atrophy

Immediately after coming from the operating room and a few hours afterward, the patient will often feel weak and fatigued. Such condition is very common since it is the result of the general anesthesia used in surgery. This is the reason why patients should not drive themselves home after a spinal stenosis surgery.

Patients usually stay in the hospital for 2 to 3 days before being discharged after a spinal stenosis surgery, but due to complications, they may be asked to stay longer. By staying in bed for a long period without any physical activity, the muscles gradually weaken and may even atrophy. To avoid this situation, patients are advised to walk around as soon as they are feeling better. A physical therapist may even be suggested.

Final Thoughts

While every surgery has a risk of complications, these problems may be prevented or mitigated through proper care.