Many thousands of people undergo some form of back surgery each year and for the majority the results will be positive, with relief from symptoms and few, if any, complications.  Unfortunately, as with any surgery, spinal surgery has a number of possible risks which need to be taken into account when making treatment decisions.  In some cases of back pain, conservative therapy suffices, and patients do not require back surgery.  If, however, after six months or so of conservative treatment, there is little improvement in the back condition surgery is likely to be considered.

Different strategies are available to reduce the risks associated with back surgery, with patients advised to quit smoking, reach an optimal weight prior to surgery, be clear of infections, and to follow both pre- and post-surgical guidelines carefully to optimize the benefits of spinal surgery.

Risks of back surgery include:

  • infection
  • bruising
  • bleeding
  • nerve damage
  • dural tear
  • paralysis
  • muscle weakness

Hardware failure, non-union (arthrodesis) in spinal fusion procedures, slippage of the spine, implant movement, and fracture are also possibilities in some of the more complex spinal surgeries and further surgery may be necessary to correct such problems.  During the procedures themselves, there are risks associated with the anaesthetic used, circulatory concerns such as thrombophlebitis (blood clots), and respiratory and cardiovascular issues.

Surgeons will assess each patient’s suitability for surgery on a case by case basis, taking into account their history of symptoms, other pertinent medical conditions, physiology, and expectations regarding the benefits of back surgery.  In some cases the level of risk will be considered too high when weighed against the potential benefits of back surgery.  For elderly patients, or those in poor general health the risk of a prolonged and uncomfortable recovery from an invasive procedure may deter them from surgery and leave them resorting to conservative and alternative back pain treatments instead.  For others, back surgery may be immanently necessary due to acute spinal trauma and the potential for permanent nerve damage if repair work is not carried out forthwith.

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