Possible Complications

General Risks

Surgery does carry with it the general risks associated with having an anaesthetic. These will depend to some degree upon your age, your general state of health and any other specific medical problems that affect you. These risks are low but should not be ignored and it must always be remembered that some complications, although rare, can be very serious and certain unforeseen circumstances can even lead to death. However, clinical experience and many studies show us that these risks are very unusual and for the vast majority of patients surgery proceeds entirely uneventfully. If you have concerns about your specific risks or feel any issues have not been answered please feel free to ask at any stage.

Risks related to the Surgery

Gaining access to the intervertebral disc does involve retracting some large blood vessels, with a small risk that one of the vessels could be torn leading to heavy bleeding. Retracting these vessels also results in a slight increase in the risk of a deep vein thrombosis.

Passing down in front of the lowest disc (L5/S1) are a number of very thin nerves which need to be moved to one side before the disc itself is removed. There is a very small risk that this could lead to some damage to these nerves which in the male may result in retrograde ejaculation. In the male the nerves control sphincters which prevent the ejaculate from passing backwards into the bladder. If the nerves are damaged ejaculation may not be normal. Erection and orgasm will not be affected, but this problem could affect your fertility. Older studies suggested that this problem could occur in 1% of men having this type of surgery but the risk seems to be much lower with current surgical techniques (particularly the retroperitoneal approach). Nonetheless, if this problem is of concern then we can arrange for sperm banking at The Spine Clinic for you.

There is a very small risk of a haematoma (blood clot) forming under the skin but if this does occur it will usually resolve spontaneously. If you are quite overweight this risk is a little higher. As with all operations there is a small chance of a wound infection occurring.

Risks arising from the use of pedicle screws and rods

There is a small risk of problems related to the use of screws in the spine. Although inserting screws into the spine sounds very alarming the use of pedicle screws has become routine now. Nonetheless, the screws must be inserted very close to the nerve roots in the spine and there is a small risk of nerve root injury. There is a very small risk to the nerve roots during the clearance of the disc with the anterior surgery. There is also a small risk that the screws may loosen or break. If this occurs further surgery may be required.

Risks arising from the use of the STALIF cage

There are no specific risks arising from the use of the cage itself.

Risks arising from attempting to fuse the spine

The principle risk here is that a fusion may fail to develop. The risk is small but, just as sometimes fractures don't mend, occasionally a fusion may fail. This is called a pseudarthrosis and is may require further surgery. The risk is certainly higher in smokers and if you do smoke you would be very strongly recommended to stop well before your surgery (and not start again afterwards). The risk is also higher if you have had surgery before. The risk of a failure of fusion is higher if more than one level is being fused. In certain cases Mr Boeree may recommend the use of Bone Morphogenic Protein (BMP) to improve the chances for a successful fusion.

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