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Spinal surgery leads to higher rate of complications

Most studies use already-reported data instead of following patients from the start

For patients with severe back issues that don't respond to other forms of conservative (non-surgical) treatment, deciding what to do next is difficult. Surgery should only be considered in these situations, but the cost and risk of complications, or adverse events from it are important factors that need to be weighed by patients. Though figures exist on adverse events following spine surgery, most studies have been retrospective (looked back on past data), making the number and severity of adverse events unclear. To better clarify this and help patients make more educated decisions, a prospective study was conducted that followed patients having spinal surgery and kept track of any adverse events afterwards.

Nearly 1,000 patients have surgery and are monitored for one year

Over one year, 942 patients underwent spinal surgery for various reasons. Conveniently, half of these patients (471) had elective surgery—based on their own decision—and the other half had surgery for emergencies. Patients were monitored using the Spine AdVerse Events Severity system, version 2 (SAVES V2), which consisted of 14 specific intraoperative (during surgery) and 22 specific postoperative (after surgery) adverse events. A team headed by spine surgeons also met once a week for the entire year to discuss the status all patients that had recently undergone spinal surgery.

Many more adverse events are identified than previous literature reports

Overall, figures from the SAVES V2 system were significantly higher than previous reports indicated. A total of 113 intraoperative and 1,850 postoperative adverse events were recorded, and postoperative adverse events were identified in all 942 patients. This is in stark contrast to the previous year, where out of 918 patients, only 89 intraoperative and 184 postoperative adverse events were recorded. The most common postoperative adverse events were electrolyte imbalance (46% of all patients) and medication side effects (41%), but some patients also experienced cardiac (8%), pulmonary (7%) and psychiatric (6%) issues. Understanding the potential for complications and side effects is extremely important for patients considering spine surgery. These results should present a clearer picture of how likely adverse events are and help patients evaluate their treatment options from a more educated standpoint before deciding to proceed with conservative treatment or elect to have surgery.

-As reported in the January '12 issue of The Spine Journal

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