Instrumentation-Related Complications of Spinal Surgery

Abstract

Complications arising from spinal surgery instrumentation present a host of challenges in diagnosis, treatment, and prevention. The spinal cord, nerve roots, and vascular and visceral structures all are vulnerable to injury caused by improper implant positioning, implant fixation failure, or a combination of these. Adverse events related to instrumentation, ranging from the benign to the catastrophic, may be detected intraoperatively or following surgery. Although a number of innovative new techniques have been developed to treat these complications, currently there exist no Level I or Level II standards by which to evaluate these methods. The absence of such data is perhaps due to a confluence of legal, financial, and social pressures that lead to underreporting. An established registry for documentation of instrumentation-related failures and complications of spinal surgery not only would heighten collective understanding among the orthopaedic community of diagnosis, treatment, and prevention of such complications, but it also would result in improved patient care.

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