The #1 Killer Complication After Spine Surgery But It’s Preventable
Preventing Dangerous Complications After Spine Surgery
The Number One Killer Complication After Spine Surgery
What’s the number one killer complication after spine surgery? As a board-certified neurosurgeon, I’ve seen how a simple blood clot can turn a routine recovery into a life-threatening emergency. But here’s the good news. Most serious complications are preventable with proper preparation and following your post-operative instructions. Let’s discuss this further.
Two Patients, Two Very Different Outcomes
Let me tell you about two patients, Sarah and Michael. Both had the same spine procedure, but their outcomes couldn’t have been more different. Sarah skipped her pre-surgery preparation, thinking it wasn’t that important. She didn’t take her instructions seriously and she stayed in bed too long after surgery. She refused to wear her compression stockings on her lower legs and when she went home, she took too much pain medication, hoping to be completely pain-free in her early recovery.
Sarah quickly developed a dangerous blood clot in a large vein in her leg, which traveled to her lungs and was nearly fatal. She was rushed back to the hospital and immediately started on a strong blood thinning medication to treat the clot. But unfortunately, this resulted in bleeding around the nerves of her spine where she had just had spine surgery. This caused a massive hematoma surrounding all of the nerves going to her legs, bowel, and bladder. She was paralyzed from this and required emerent surgery to remove the bleeding around her spine. She spent months living in an inpatient rehabilitation center attempting to regain the ability to walk. She developed soores on her skin where she was predominantly bedbound and she also required additional medical treatment for her injured lungs from that initial blood clot.
Michael, however, followed every pre-surgery recommendation meticulously. He got up walking as soon as possible after the procedure and followed every medication instruction carefully. His recovery was smooth and he was back home in just two days, grateful for his surgery, which had dramatically improved his quality of life.
Why Preparation Matters So Much
As a board-certified neurosurgeon who’s performed thousands of spine surgeries, I can tell you that what you do before and immediately after surgery is just as important as the procedure itself. Studies show that proper preparation can reduce complication rates by up to 30%. This doesn’t mean that complications are always the result of a patients actions or inaction. Many patients follow every guideline after what seems to be a smooth spine surgery. Yet, unexpected complications can still occur. However, there are steps you can take to reduce those risks. and I’m here to guide you through them, helping you set yourself up for the best possible outcome.
Six Key Areas to Reduce Your Risk of Complications
Let’s start with the most critical aspects of surgery preparation, breaking them down into six key areas that will significantly reduce your risk of complications.
1. Manage Your Medications Appropriately
Number one, manage your medications appropriately. First, let’s talk about medications. This isn’t just about making a list. It’s about preventing dangerous interactions that could lead to serious complications. Create a comprehensive list of all medications. Include over-the-counter drugs and supplements. Document exact dosages and frequency. Share this information and your pharmacy information with your surgical team as you may be required to hold certain medications before and after surgery. And note any drug allergies.
2. Prepare Your Home Environment
Number two, prepare your home environment. Your home setup can make the difference between a smooth recovery and a dangerous fall. Here’s what you need to do. Move frequently used items to waste level. This can include shoes, clothing, food, medicines, and toilet paper. Purchase a reacher so you can reach items stored above or below waist level. Remove trip hazards like rugs, cords, chairs, or items for your pets. Use a toilet seat rise or commode for your toilet. Install night lights in key areas of your home. Prepare a dedicated recovery space where it’s easy and safe for you to move around. Stock up unnecessary supplies. Consider preparing meals in advance. Clean your bed sheets and towels. And consider purchasing a long-handled shoe horn and a sock aid to help you put your socks and shoes on without bending.
3. Prepare Yourself Physically
Number three, prepare yourself physically. This is where you can significantly reduce your risk of complications. This includes quitting smoking, maintaining a healthy weight, and controlling your blood sugar levels.
In regards to smoking sessation, quit all nicotine products. This includes vaping and patches. These toxins not only affect your body’s ability to heal from surgery, but they also affect the ability for your bones to fuse, which could be a requirement for the specific surgery you’re having. Start this at least 6 to 8 weeks before surgery.
Weight management is incredibly important in spine surgery. Obesity can substantially increase your risk of having complications from spine surgery and it can worsen long-term outcomes. Maintain a healthy body mass index if possible. Every pound matters when it comes to surgical risk. Work with a nutritionist if needed and focus on high protein richch foods.
Blood sugar control is also imperative during and after spine surgery. Poor glucose control can increase infection risk, lead to poor wound healing, delay your recovery, and increase risk of cardiovascular events such as heart attacks and strokes. It can also affect how your body responds to medications for anesthesia. Work with your doctor to optimize your blood sugar control if needed. Monitor your levels regularly, and you may need medication adjustments prior to surgery.
4. Actively Prevent Specific Complications
Number four, take action to avoid some specific complications like deep venus thrombosis, pneumonia, constipation, and infection.
Deep venus thrombosis or DVT is when you develop a blood clot in one of the deep veins, often in your legs. This clot can break loose and travel through your veins to your lungs. This can cause significant lung injury, but it can also result in death. To minimize your risk of a DVT after surgery, use compression devices on your legs as directed. Start walking as soon as safely possible. Perform ankle pumps every hour while awake and especially if you’re sitting or in bed. Stay hydrated and report any leg pain or swelling immediately to your medical team.
To prevent pneumonia, practice deep breathing exercises. Use your incentive sperometer 10 times per hour. Get up and walk frequently. Sit upright for meals and complete your breathing exercises before surgery in addition to after.
To minimize your risk of infection, follow your pre-surgery shower instructions. Keep your incision clean and dry, including keeping pets away from your incision. Sleep on clean sheets. Maintain good blood sugar control and avoid nicotine products. And optimize your nutrition. Watch for signs of infection such as significant redness, swelling, and pain along the incision, drainage of pus, and fevers. Notify your surgeon immediately if you notice these signs and symptoms.
Let’s talk about constipation. Anesthesia and narcotic pain medication can slow the normal action of your bowels, which can cause constipation. This may result in abdominal distension, bloating, and discomfort, which can be quite extreme in certain instances. You can prevent constipation by consuming a healthy high-fiber diet rich in fruits, vegetables, and high-fiber cereals. Drinking at least 6 8 oz glasses of water each day and walking regularly can dramatically reduce your risk of constipation. Minimizing your narcotic pain medications when able and taking stool softeners daily. I advise my patients to continue taking stool softeners after surgery until they are off narcotic medications and having regular bowel movements.
5. Develop a Smart Pain Management Strategy
Number five, develop a pain management strategy. Pain is expected after spine surgery. You can expect it to be worse in the first 2 to 3 days after surgery, then it gets better every day thereafter. Over the following couple weeks, you may experience occasional nerve related pains or tingling sensations in your arms or legs as your nerves are healing. This is not uncommon and it will go away over time. If you’re concerned, don’t hesitate to reach out to your surgeon for guidance. They can assess your symptoms and let you know what’s normal and when something might be more worrisome.
Your goal after surgery is to keep your pain at a tolerable level, not to be completely pain-free. You will likely be prescribed pain medicine to help with your pain, including narcotic medication and a muscle relaxer. Both can cause drowsiness, confusion, and constipation. So, use these medications sparingly and only as needed. Use ice as needed to decrease swelling at the incision site. Use additional means of managing your pain, like relaxation and distraction, such as reading a book or watching television. Studies have shown that music is a great way to reduce pain by up to 20%. Essentially develop a multimodal approach to your pain management. Use prescribed medications as directed, ice therapy for inflammation, proper positioning techniques, relaxation strategies, and music therapy.
Now, here is an important safety note. I cannot stress this enough. Your goal is to keep your pain at a tolerable level, not eliminate it completely. Over medication can lead to its own complications, including injury and dangerous life-threatening breathing problems.
6. Follow a Structured Post-Surgery Protocol
Number six, follow a post-surgery protocol. Studies show that patients who follow a structure protocol have a 65% lower risk of complications. This is another area where you can actively participate in your surgical success. Mobilize early. Start moving every 4 hours after surgery. Manage your pain appropriately. Aim for a healthy level of tolerated discomfort as opposed to a goal of being completely pain-free. Perform your deep breathing exercises. Keep yourself properly hydrated. Regularly monitor your wound. Gradually increase your activity and participate in physical therapy if and when instructed by your surgical team.
Spine surgery is a significant step, but with proper preparation, you can substantially reduce your risk of complications. Recovery isn’t a race. It’s a process. Having everything prepared in advance and following proper postsurgery plan will optimize your success at healing.
Recap: Key Steps for a Safer Spine Surgery and Recovery
Let’s recap the key points for successful and safe spine surgery. Preparation is crucial. This includes medication management, home environment setup, physical conditioning, hospital preparation, and recovery planning.
Furthermore, complication prevention is vital. Prevent DBT through early mobility. Prevent pneumonia with breathing exercises. Minimize risk of infection through proper wound care, good blood sugar control, and avoiding toxins like nicotine. And protect your spine through proper body mechanics.
Remember, knowledge is power. By following these preparation steps and staying vigilant about complication prevention, you are setting yourself up for the best possible outcome. Want to learn more about spine surgery and how to make this a success for you or your loved one? Subscribe to this channel where I break down complex spine topics into clear, actionable information. And please like, subscribe, and share with anybody you think may benefit from this information. Thank you for watching and I’ll see you next time.