October 2017 Edition. Volume XVII

What Are the Basic Risks of Spine Surgery?

Death
Paralysis
Nerve Injury

Wound Infection (see Prevention)
Emboli
Medical Problems
Drug Reactions

What Are the Statistics?

The risk of death or permanent brain injury from  general anesthesia is one case in 250,000 patients.

In order to keep this statistic in proper perspective let’s compare it to other known death risks: Being an astronaut: 1 in 100 Driving an automobile: 1 in 6,000 Flying in a commercial airliner: 1 in 10,000,000

The risk of a significant neurologic complication in spine surgery is  about 1.5%.

Of the 30 million surgeries performed annually in the United States each  year the infection rate is 2.6%.

In spine surgery the risk of deep tissue wound infection is 2.3% in simple decompression  and 5% in fusion procedures.

The overall risks associated with fusion tend to be three times higher than those  of decompression.

(Just remember the greatest risk of having surgery can be the drive to the hospital)

From the above it should be clear that all surgery is fraught with potential complications. The only legitimate reason for a patient to have surgery is that the benefit compared to the risk involved, is significantly higher.  This applies only when the patient is presented with, and understands, the true risks. Even when surgery is successful and not associated with any significant complications there is no guarantee that the patient will continue to do well.  The continuing success of a surgical procedure may depend on a host of factors including:

Post-surgical wound breakdown and/or infection. Post-surgical ileus, pneumonia, thrombophlebitis, etc. Existing disease or drug sensitivities (not necessarily known) producing adverse reactions. Patient compliance with post-surgical orders and recommendations. Patient compliance with post-surgical health maintenance programs.

The sooner after surgery a patient becomes ambulatory the less are their post-operative problems.

Medical Mistakes

Medical care, whether provided by physicians, nurses or others depends on human beings and human beings can make mistakes.  Minor mistakes are commonplace in any health care system, they rarely cause problems, and simply reflect a human element which will always be present to some degree.  Responsible health care organizations typically have existing systems of checks and balances to help prevent minor errors from becoming major problems.  The serious mistakes are the primary subject of concern.  The Institute of Medicine, affiliated with the National Academy of Sciences, has estimated that 100,000 people die in hospitals in the United States each year because of medical mistakes.  The principal reason for this is not just careless physicians or nurses but faulty medical systems.  Even though the United States probably has the best safety record in the world today (statistics unavailable on this) it is clear that more “sunshine overview” (routine post-operative reporting of patient satisfaction) and reporting of incidence and prevalence of medical mistakes is needed.

How can a patient protect them self against medical mistakes?  The answer is to become a well informed medical consumer and choose physicians and hospitals with care.  Institutions with poor communication, low moral, poor system management and poor supervision associated with poor working conditions will make more medical mistakes.

The Trial Lawyers Viewpoint

Trial lawyers often have a skewed view of surgical complications; they sometimes consider any medical mistake to be akin to assault and battery by reckless medical personnel.  Sometimes the circumstances do indeed justify such a description but it is important to point out that this is not commonplace.  The great majority of medical professionals are competent, concerned, and dedicated to the welfare of their patients.  Admittedly the means by which patients can find this out, in advance, are, at the present time, limited.

 

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