====== Spine surgery complications ======

[[Complication]]s in [[spine surgery]] can arise in the [[intraoperative]] or the immediate [[postoperative]] period or in a delayed manner. These complications may lead to severe or even permanent [[morbidity]] if left undiagnosed and untreated. 

Complication rates after spinal surgeries are still high, especially in patients with [[spinal metastases]] and poor clinical status ([[KPS]]), requiring revision surgeries in several cases. Therefore, specific risk factors should be determined to carefully select surgery groups
((Lange N, Stadtmüller T, Scheibel S, Reischer G, Wagner A, Meyer B, Gempt J. Analysis of risk factors for perioperative complications in spine surgery. Sci Rep. 2022 Aug 23;12(1):14350. doi: 10.1038/s41598-022-18417-z. PMID: 35999446.)).
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[[Gelfoam ]]is widely used in spine surgery and its [[complication]] is rare. Gelfoam has been used to control the bleeding and prevent scar adhesion when used after laminectomy as an effective interposing membrane.

===== Arterial air embolism =====

[[Arterial air embolism]].

===== Cerebrospinal fluid fistula =====

see Spinal [[Cerebrospinal fluid fistula]].

===== Intracranial Hemorrhage following Spine Surgery =====

[[Intracranial Hemorrhage following Spine Surgery]].

===== Pneumocephalus =====

see [[Pneumocephalus]].

===== Spinal epidural hematoma =====

see [[Spinal epidural hematoma]].

===== Spinal subdural hematoma =====

see [[Spinal subdural hematoma]]

===== Spinal infection =====

see [[Spinal infection]].

===== Surgical site infection =====

[[Surgical site infection in spine surgery]]
===== Venous thromboembolism =====

see [[Venous thromboembolism]].

===== Wrong-site surgery =====

[[Wrong-site surgery]]
===== Case series =====

459 patients who were divided into 5 groups: group 1, patients with cervical degenerative disease treated with posterior decompression; group 2, patients with cervical degenerative disease treated with instrumentation for spinal fusion; group 3, patients with thoracolumbar degenerative disease treated with instrumentation for spinal fusion; group 4, patients with lumbar spinal stenosis treated with posterior decompression; and group 5, patients with lumbar spondylolisthesis treated with 1-level posterior lumbar interbody fusion. A deep venous thrombosis and [[pulmonary embolism]] (PE) screening was performed for all patients. Binomial logistic regression analysis was used to assess the association of risk factors.

The incidence of VTE was 2.8%, 3.4%, 10.8%, 12.5%, and 10.1% in groups 1, 2, 3, 4, and 5, respectively. Female sex, advanced age, spinal level, and neurological deficits, were all risk factors. Cervical spinal surgery in particular had an associated low risk. In patients with PE, 3 of the 4 had no deep venous thrombosis, indicating that screening for PE is also needed in high-risk patients.

The prevalence of venous thromboembolism (VTE) after elective spinal surgery was different in each group
((Yoshioka K, Murakami H, Demura S, Kato S, Tsuchiya H. Prevalence and risk
factors for development of venous thromboembolism after degenerative spinal
surgery. Spine (Phila Pa 1976). 2015 Mar 1;40(5):E301-6. doi:
10.1097/BRS.0000000000000727. PubMed PMID: 25494320.
)).