What are the risks, side effects, and possible
complications?
Generally speaking, most procedures are safe. However, with any procedure there
are risks, side effects, and the possibility of complications. The risks and
complications are dependent upon the site of the procedure performed. The
closer to the spine, the more serious the risks are. Great care is taken to
prevent possible problems. Nevertheless, complications can still occur. The
following is not meant to be interpreted as a list of all possible problems.
Remember that unforeseen complications can occur.
1. Infection: Any time the skin is surgically
manipulated there is a risk of infection. Sterile technique and antibiotics are
used in an attempt to prevent infections. There are five possible types of
infection:
a. Localized skin infection.
b. Central Nervous System infection ń
this can be in the form of meningitis, which can be deadly.
c.
Epidural
Infections ń this can be in the form of an epidural abscess, which can cause
pressure inside of the spine, causing compression of the spinal cord with
subsequent paralysis. This would require an emergency surgery to decompress,
and there are no guarantees that the patient would recover from the paralysis.
d. Discitis ń this is an infection of
the intervertebral discs. It occurs in about 1% of discography procedures. It
is difficult to treat and it may lead to surgery.
e. Osteomyelitis ń this is a bone
infection, very rare, but also very difficult to treat due to poor blood flow
to the bones. This may also require surgery to treat.
Note:
In the case of implants, infections may require the removal of the implant.
2. Pain: All surgeries are expected to have a
postoperative recovery period where you may hurt more than usual, until the
affected tissue heals and recovers.
3. Damage to
internal structures:
Nerves and blood vessels can potentially be damaged. Please discuss your
specific concerns with your physician.
4. Bleeding: Bleeding is more common if the
patient is taking blood thinners such as aspirin, Coumadin, Ticlid,
Plavix, etc., or if he/she have some genetic predisposition such as hemophilia.
Bleeding into the spinal canal can cause compression of the spinal cord with
subsequent paralysis. This would require an emergency surgery to decompress and
there are no guarantees that the patient would recover from the paralysis.
5. Pneumothorax: Puncturing of a lung is a
possibility, every time there is work done in the area of the chest or upper
back.
6. Spinal
headaches: They may
occur with any procedures in the area of the spine.
7. Spinal fluid
leaks: This may
cause a persistent headache or accumulation of fluid in the pocket site. It may
require surgery to correct.
8. Nerve
damage: By working so
close to the spinal cord, there is always a possibility of nerve damage which
could be as serious as a permanent spinal cord injury with paralysis.
9. Death: Although rare, severe deadly
allergic reactions known as ěAnaphylactic Reactionî can occur to any of the
medications used.
10. Worsening of
the symptoms: We can
always make things worse.
11. Seromas: This is an accumulation of fluid at
the surgical site, most commonly seen at the ěpocket siteî of the implant. It
can last several weeks to months, and it may need to be drained several times,
until it stops recurring. It also has the potential of getting infected,
requiring removal of the Implant.
What are the chances of something like this happening?
Chances of any of this occurring are extremely low. By statistics, you have more of a chance of getting killed in a motor vehicle accident, while driving to the Hospital, than any of the above occurring. Nevertheless, you should be aware that they are possibilities.
Who should not have this procedure?
If you are on a blood thinning medication (e.g. CoumadinĆ,
PlavixĆ, see back), or if you have an active infection going on, you
should not have the procedure. If you are taking any blood thinners, please
inform your physician.
How should I prepare for this procedure?
…
Do
not eat or drink anything, at least six hours prior to the procedure.
…
Bring
a driver with you. Cannot be a Taxi.
…
Take
all of your medicines the morning of the procedure, with just enough water to
swallow them. If you have diabetes, do not take your Insulin or your sugar
pills (oral hypoglycemics) until after the procedure.
…
Do
not take aspirin or any aspirin-containing medications, at least eleven (11)
days prior to the procedure. They may prolong bleeding.
…
Do
not take any non-steroidal anti-inflammatory drugs, at least one day prior to
the procedure. They may prolong bleeding.
…
Wear
loose fitting clothing that may be easy to take off and that you would not mind
if it got stained with Betadine or blood.
…
Take
a shower the morning of the procedure, using a bactericidal soap to minimize
chances of infection.
…
Do
not wear any jewelry or perfumes.