Complications of decompressive lumbar spine procedures without instrumentations – an institutional experience

Abstract

Background Till now, there is insufficient documentation of operative complications in spine surgery, and the expected results are far less predictable if the actual indication for surgical intervention is not clear. Complication could be defined as 'a condition that directly or indirectly results from surgical intervention and disrupts the planned outcome of the surgery.' So, spine surgeons should be aware of these events and know how to deal with them. Aim To detect the number and percentage of moderate and/or major operation-related complications associated with the relatively repeated and popularized neurosurgical procedures performed at the Neurosurgical Department, Shebin Elkom Teaching Hospital, to analyze our work in relation to published literature that addresses this topic, so as to optimize the future practice. Patients and methods A retrospective study was conducted on documented operation-related complications of patients operated upon at the Neurosurgical Department, Shebin Elkom Teaching Hospital, between March 2011 and March 2019. This study involved patients who underwent decompressive lumbar spine procedures without instrumentation. The operations were performed by neurosurgeons with the same professional degree but with different number of operated cases. Any decompressive surgery with instrumentation techniques was excluded. Results A total number of 3496 patients were operated upon between March 2011 and March 2019, of whom 1087 fulfilled the inclusion criteria. Their medical records were reviewed for documentation of the existed complications related to surgery. The number of documented moderate and/or major operation-related complications was 124 (11.41%) cases from the total number of the studied group. Conclusion Till now, there is insufficient inclusive documentation of operative complications in spine surgery. In this study, the number and percentage of moderate and/or major complications related to different decompressive lumbar surgery techniques without instrumentations could be detected, and it was found that most of the identified complications lie within the reported incidence. With insightful understanding of these complications, surgeons could adequately analyze and evaluate risk factors in patients and procedure-related factors and then develop preventive measurements to reduce the rate of these complications.