Dr Adriaan Liebenberg My Spine Lumbar | Page 90

My Spine - Lumbar Explanation: Unexpected events can take place during or after operations. This can include reactions to medications, a heart attack, a stroke, kidney fail- ure, lung failure, blood clots in the legs or severe infections. Each one of these conditions will require further treatment and rarely these are serious enough to lead to death. Risk: It is possible that the instrumentation that is used during an operation may dislodge, move or fail. Explanation: Instrumentation and prosthesis used in spinal surgery are for- eign bodies and are used to correct the alignment of the spine and to allow a bony fusion to occur. In some cases this instrumentation may fail (break), move or dislodge and can compress sensitive tissue, necessitating removal or replacement of this instrumentation. Risk: It is possible that fusing a segment of the lumbar spine, may lead to accelerated wear and tear at the adjacent segments of the spine leading to further spinal surgery. Explanation: The biomechanical properties of the segment of the spine that is being fused changes and becomes less mobile. This may cause a lever action on the adjacent segments that is thought to accelerate the wear and tear at the adjacent segments. In an attempt to overcome this, it is possible in selected cases to remove the disc that is causing nerve compression and replace it with an artificial disc rather than performing a fusion (see the chap- ter Lumbar Total Disc Arthroplasty). Risk: It is possible that a major blood vessel may be damaged during sur- gery. Explanation: In anterior (from the front) surgical approaches to lumbar sur- gery, some of the major blood vessels may be damaged. These complications rates vary according to the type of surgery and many technical factors. This may be a very serious complication and may even lead to the death of the patient. 90