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 issue is of concern then we can arrange for sperm banking at The Spine Clinic for you.

The risks to the nerve roots is much lower with the anterior approach to clearing away the disc but there is still a very small chance that a nerve root could be injured, either during clearance of the disc or due to stretching as the disc height is restored. If this occurs it could affect one leg, resulting in a patch of numbness, some weakness of certain muscles or sciatic pain. If it is due to stretching or bruising of the nerve root, which is not unusual, the symptoms will usually resolve quite quickly.

There is a very small risk of a haematoma (blood clot) forming under the skin but if this does occur it will usually resolve itself straight away. If you are quite overweight this risk is a little higher, in which case a drain may be inserted to minimise the risk. As with all operations there is a small chance of a wound infection occurring.

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 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 a failed fusion operation 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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