Potential Complications of Surgery

With any surgery, there is a risk of complications. When surgery is done near the spine and spinal cord these complications (if they occur) can be very serious. Complications could involve additional pain and impairment and the need for additional surgery. You should discuss the complications associated with surgery with your doctor before surgery. The list of complications provided here is not intended to be complete and is not a substitute for discussing the risks of surgery with your doctor. Only your doctor can evaluate your condition and inform you of the risks of any medical treatment he or she may recommend.

• Anesthesia - any surgery that requires anesthesia can be potentially harmful. Surgery on the cervical spine usually requires that you be put under general anesthesia. General anesthesia means that you are put to sleep. Anesthesia carries a risk of allergies to the medications. There are also different life-threatening situations that can occur during anesthesia. It is extremely unlikely that these complications will occur, but you should be aware that they are possible.
• Infection - any surgery involving an incision in the skin can become infected. In addition, the bone graft and area around the spine may become infected. An infection will usually require some type of antibiotic medication to treat the infection. If the infection involves the bone, it may require one or more additional surgeries to drain the infection. The risk of infection is usually less than one percent.
• Blood Vessel Damage - there are large arteries and veins that travel through the neck into the brain. The carotid artery and the jugular vein are nearby. It is possible to damage these blood vessels during the surgery. Again, it is extremely unlikely that this will occur, probably less than one in a thousand.
• Nerve Damage - there are nerves in the neck that travel along the area where the incision is made to perform an anterior cervical discectomy and fusion. These nerves go to the vocal chords. There is the possibility that these nerves can be damaged during surgery. This can lead to hoarseness. If this occurs, it will usually recover unless the nerve is permanently damaged or cut. Again, this is unlikely.
• Spinal Cord Damage - surgeries that are performed on the cervical spine place the spinal cord at risk for injury. Spinal cord damage is probably much more likely in the larger, more serious operations such as the corpectomy and strut grafting procedures. These are complex, difficult operations and are done for extremely serious problems that are unlikely to respond to any other type of treatment. Routine anterior discectomy and fusion are common surgeries that are extremely safe. While damage to the spinal cord is possible, it is highly unlikely.
• Graft Displacement - one of the more common problems that can occur after an anterior cervical discectomy and fusion is that the bone graft may move out of position. If it moves too much, it may require a second surgery to place a new bone graft in its place.
• Non-Union - in spite of a successful surgery and good bone graft, a fusion may not occur between the vertebrae. This is termed a non-union or pseudarthritis. Usually your surgeon will be able to tell whether a fusion has occurred by looking at X-rays taken over a three- to six-month period after surgery. If a fusion does not occur and you have no pain, a second surgery will not be necessary. If you continue to have pain, and a non-union is diagnosed after surgery, your surgeon may suggest a second attempt at fusion. When trying for the second time after a failed fusion, most surgeons will usually include some type of internal fixation, such as a plate and screws.