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Complications & Recovery

Post-operative spine complications including cervical hematoma, dysphagia, and dural tears — incidence rates, risk factors, and management of acute sequelae.

Overview

Lumbar disc surgery and posterior lumbar fusion carry inherent risks of special complications, though the overall incidence in lumbar disc procedures is not excessively high [4]. In posterior lumbar fusion specifically, approximately one-third of adverse events are diagnosed between 31 and 90 days post-surgery [1]. For thoracic spinal stenosis, the peak period for unplanned hospital readmission occurs from 10 to 40 days after the procedure [12]. Conversely, minimally invasive total hip arthroplasty is a safe surgical approach that does not increase operative time, blood loss, complication rates, or component malposition rates compared to open techniques [14].

Complication profiles vary significantly by procedure and anatomical site. Transolecranon distal humerus fracture fixation is associated with high rates of deep infection and nonunion, frequently resulting in long-term functional limitations [6]. Limb salvage surgery for ankle sarcomas also presents with common complications [16]. In contrast, arthroscopic approaches generally yield lower overall complication rates than open debridements [15], and practice with the procedure combined with careful patient selection can reduce risks in trans-sacral epiduroscopic lumbar decompression [22]. While minimally invasive total hip arthroplasty offers safety benefits, its specific beneficial effect on functional recovery requires further proof [14].

Specific adverse events require distinct diagnostic and management considerations. Deep peroneal-nerve injury from arthroscopic meniscectomy can result in persistent motor loss necessitating surgical nerve grafting, with only partial recovery observed one year post-operatively [3]. Perioperative vision loss remains a rare but devastating complication with a poor prognosis and no proven effective treatment; prevention relies on avoiding direct eye pressure, optimizing hemodynamics, and minimizing surgical time [8]. Differentiating Guillain-Barré syndrome from other postoperative spinal complications often requires analyzing the timing of symptoms, imaging results, and the development of atypical features [2]. A review summarizes the diagnostic and treatment processes for complications following reverse shoulder arthroplasty [7].

Anatomy & Pathophysiology

Adverse events following spinal fusion procedures present with variable timing and severity depending on the surgical approach and patient comorbidities. Approximately one-third of adverse events after posterior lumbar fusion are diagnosed 31 to 90 days after surgery [1]. While lumbar disc surgery carries a risk of special complications, the incidence is not excessively high [4]. In contrast, adverse events associated with anterior cervical spine surgery are infrequent but can be serious and potentially life-threatening [13]. Functional outcomes for patients with spinopelvic dissociation are significantly reduced, with only one-third achieving pre-traumatic functional outcomes one year after injury [5]. Heart disease presents an additional challenge to spine fusion patients undergoing a challenging and risky procedure [58].

Complication Profiles by Pathology: The main complications of surgery for juvenile thoracic and lumbar spinal tuberculosis are postoperative aggravated kyphosis and adjacent kyphosis deformity [33]. Mono-segment fixation is more suitable for single-segment lumbar spinal tuberculosis as it preserves normal motion segments with less trauma, shorter operation time, shorter hospitalization, and lower costs [51]. Future measures for treating fibrous dysplasia of the cervical spine should emphasize maintaining spinal cord integrity and using only a minimum amount of traction [41]. Sublaminar implants in narrow, kyphotic segments likely exacerbate neural irritation through dural impingement [18].

Risk Factors and Planning: Change in Cobb angle is an independent risk factor for minor perioperative complications in long fusion for adult non-degenerative scoliosis [49]. Change in Cobb angle and spinal osteotomy are independent risk factors for major perioperative complications in long fusion for adult non-degenerative scoliosis [49]. Preoperative planning for pedicle screw insertion in adolescent idiopathic scoliosis should be based on anatomical limitations in the apical vertebra region, apical vertebra level, and apical vertebral rotation degree [47]. Preoperative screening and optimization of patients to identify and address low bone mineral density is important to improve postoperative outcomes after short fusion for degenerative lumbar disease [52].

Kinematics and Structural Assessment: Percutaneous techniques for thoracolumbar fracture in ankylosing spondylitis can improve pain, neurological function, and kyphotic deformity with effects similar to traditional methods [42]. A DiffVMVA ≤ +10° clearly identifies bony bridging of the posterior elements of a non-mobile lumbosacral transitional vertebra and the first adjacent mobile segment [54]. There is no need for additional training to improve postural control in adolescents with idiopathic scoliosis compared to healthy peers [56].

Classification

Timing of Adverse Events: Approximately one-third of adverse events after posterior lumbar fusion are diagnosed 31 to 90 days after surgery [1]. Delayed-onset neurological changes following posterior spinal fusion have been documented in a cohort of 18 patients, with an erratum correcting data errors and revising ASIA scores and recovery descriptions for this group [10].

Neurological Complications: The timing of symptoms, imaging results, and the development of atypical symptoms can help distinguish Guillain-Barré syndrome from other postoperative spinal complications [2]. Deep peroneal-nerve injury resulting from arthroscopic meniscectomy can result in persistent motor loss requiring surgical nerve grafting, with only partial recovery observed one year post-operatively [3]. Stratification based on central neuromotor impairments can help identify patients with cerebral palsy at GMFCS level 5 who are at higher risk for developing complications after spinal arthrodesis [40].

Spinal Surgery Specifics: Lumbar disc surgery carries some risk of special complications of its own, though the incidence has not been excessively high [4]. Surgical complications for lumbar disc herniation are less frequent than previously suggested [30]. A thorough understanding of complications associated with anterior lumbar surgery aids in prevention, recognition, and management of these rare problems [9].

Spinopelvic and Traumatic Outcomes: Functional outcomes for patients with spinopelvic dissociation are significantly reduced one year after injury, with only one-third of patients achieving pre-traumatic functional outcomes at that time [5]. The type of management did not significantly affect mortality in patients with traumatic central cord syndrome, whereas age at the time of injury significantly affected mortality [17].

Fracture and Joint Complications: Complication rates for transolecranon distal humerus fracture, including deep infection and nonunion, are high, posing frequent long-term functional limitations to the patient [6]. Overall rates of complication were lower following arthroscopic approaches compared to open elbow debridements in a cohort of surgeons [15]. Return to the operating room for MUA after arthrofibrosis following adolescent anterior cruciate reconstruction with quadriceps tendon with bone block autograft is similar to other graft types [46].

Oncology and Arthroplasty: Musculoskeletal oncology involves the diagnosis and management of neoplastic conditions affecting the musculoskeletal system, including benign tumors, sarcomas, and metastatic carcinoma [45]. Classification of musculoskeletal oncology conditions is based on histomorphology to yield insight into behavior and prognosis [45]. A review summarizes processes related to the diagnosis and treatment of complications after reverse shoulder arthroplasty [7].

Other Considerations: The evidence base includes specific data corrections regarding delayed-onset neurological changes [10] and highlights the need for thorough understanding of anterior lumbar surgery complications [9].

Clinical Presentation

The timing of symptom onset and imaging findings is critical for distinguishing specific etiologies. Approximately one-third of adverse events following posterior lumbar fusion are diagnosed between 31 and 90 days post-surgery [1]. In anterior cervical spine surgery, adverse events are infrequent but can be serious and potentially life-threatening [13]. Esophageal perforation presents a unique diagnostic challenge, often manifesting with delayed symptoms more than 10 years after the index procedure [36].

Neurological deficits and functional limitations vary by injury pattern and surgical intervention. Deep peroneal-nerve injury following arthroscopic meniscectomy may result in persistent motor loss requiring nerve grafting, with only partial recovery observed one year post-operatively [3]. Functional outcomes for spinopelvic dissociation are significantly reduced one year after injury, with only one-third of patients achieving pre-traumatic functional status [5]. Conversely, total resolution of spastic paraparesis can follow resection of a hypertrophied fusion mass causing late paraparesis after scoliosis fusion, with no recurrence observed at four-year follow-up [27].

Complication profiles differ significantly across fracture types and implant strategies. Complication rates for transolecranon distal humerus fractures, including deep infection and nonunion, are high and frequently pose long-term functional limitations [6]. Complications are common following limb salvage surgery for ankle sarcomas [16]. Health-related quality of life in early-onset scoliosis patients treated with growth-friendly implants is influenced by etiology, complication rate, and ambulatory ability [23].

Specific rare complications carry grave prognostic implications or require aggressive management. Perioperative vision loss is a rare but devastating complication with a poor prognosis and no proven effective treatment [8]. Symptomatic postoperative epidural hematomas and seromas are rare but potentially grave complications [20]. Once diagnosed, delayed infections following posterior spinal instrumentation for idiopathic scoliosis require removal of the spinal instrumentation, wound debridement, and primary closure [28]. Treatment with a halo vest can be completed successfully despite the presence of complications [25]. Lumbar disc surgery carries a risk of special complications, though the incidence has not been excessively high [4].

Investigations

MRI: Pre-operative sagittal whole spine MRI is indicated for patients undergoing lumbar decompressive surgery to exclude proximal neurological compression [43]. In the context of postoperative complications, the timing of symptoms, imaging results, and the development of atypical symptoms assist in distinguishing Guillain-Barré syndrome from other postoperative spinal complications [2]. Magnetic resonance imaging further indicates that the donor site after autologous osteochondral mosaicplasty for cartilaginous lesions of the elbow joint is resurfaced with fibrous tissue [55].

Plain radiography: Various imaging changes were identified after Coflex implantation, most of which did not affect clinical outcomes [50]. Anterior-posterior fusion yielded superior sagittal alignment compared to laminoplasty for multilevel cervical ossification of the posterior longitudinal ligament [11].

Other Considerations: Approximately one-third of adverse events after posterior lumbar fusion are diagnosed 31 to 90 days after surgery [1]. Adverse events associated with anterior cervical spine surgery are infrequent but can be serious and potentially life-threatening [13]. Deep peroneal-nerve injury resulting from arthroscopic meniscectomy can result in persistent motor loss requiring surgical nerve grafting, with only partial recovery observed one year post-operatively in the reported case [3]. Symptomatic postoperative epidural hematomas and postoperative seromas are rare but potentially grave complications [20]. Disc-space infection and subsequent spontaneous interbody fusion following bowel perforation were followed by satisfactory recovery [19]. Once diagnosed, delayed infections following posterior spinal instrumentation for idiopathic scoliosis require removal of the spinal instrumentation, wound debridement, and primary closure [28]. Treatment of complications in children managed with immobilization in a halo vest can be completed successfully with careful planning and meticulous attention to detail [25]. Management of heterotopic ossification following traumatic brain injury and spinal cord injury is aimed at limiting its progression and maximizing function of the affected joint [31]. The main complications of surgery for juvenile thoracic and lumbar spinal tuberculosis were postoperative aggravated kyphosis and adjacent kyphosis deformity [33]. Subsequent vertebral body fractures occurred in 19.2% of patients after posterior stabilization of unstable geriatric fractures of the thoracolumbar spine and were significantly associated with higher pain levels and worse ODI scores [53]. One-third of patients with spinopelvic dissociation achieved pre-traumatic functional outcomes one year after injury [5]. Anterior-posterior fusion was associated with higher early postoperative disability, most pronounced in segmental-type OPLL, though differences in functional outcomes between anterior-posterior fusion and laminoplasty diminished by the second postoperative year [11]. A review summarizes processes related to the diagnosis and treatment of complications after reverse shoulder arthroplasty [7]. Lumbar disc surgery carries a risk of special complications, but the incidence has not been excessively high [4]. A thorough understanding of complications associated with anterior lumbar surgery aids in prevention, recognition, and management [9].

Treatment

Non-Operative

Close observation and medical management can be an effective strategy to induce spontaneous regression of spinal epidural hematoma in patients presenting with mild neurological symptoms [32]. Management of heterotopic ossification following traumatic brain injury and spinal cord injury is directed at limiting progression and maximizing the function of the affected joint [31]. Practice with the procedure and careful patient selection can lower the risk of complications following trans-sacral epiduroscopic lumbar decompression for lumbar disc herniations [22].

Operative

Indications: A thorough understanding of complications associated with anterior lumbar surgery aids in the prevention, recognition, and management of these rare problems [9]. Appropriate strategies must be utilized to avoid adverse events associated with anterior cervical spine surgery, and surgeons must understand how to detect and manage them when they arise [13]. Adverse events associated with anterior cervical spine surgery are infrequent but can be serious and potentially life-threatening [13].

Surgical Approach / Technique: Closed subarachnoid drainage is a reasonably effective and safe method for treating dural-cutaneous cerebrospinal-fluid leaks after a spinal operation [48]. Closed subarachnoid drainage may be considered a non-operative alternative to reoperation and direct repair of the dura [48]. Minimally invasive total hip arthroplasty (MIS THA) is a safe surgical procedure without increases in operative time, blood loss, operative complication rates, or component malposition rates [14].

Implant Selection: Anterior–posterior fusion (APF) yielded superior sagittal alignment but was associated with higher early postoperative disability compared to laminoplasty, most pronounced in segmental-type OPLL, though differences diminished by the second postoperative year [11]. For patients with spinopelvic dissociation, functional outcomes are significantly reduced and only one-third of patients achieved pre-traumatic functional outcomes 1 year after the injury [5].

Alignment / Balancing Strategy: More severe pain immediately after surgery did not result in a higher incidence of chronic pain in the no drain group compared with the drain group after posterior spinal fusion in patients with adolescent idiopathic scoliosis [44].

Pain Management: The goals of therapy for postoperative spinal wound infections include eradicating the infection, relieving pain, preserving or restoring neurologic function, improving nutrition, and maintaining spinal stability [34].

Adjuncts: Perioperative vision loss is a rare but devastating complication with a poor prognosis and no proven effective treatment [8]. Prevention of perioperative vision loss through strategies such as avoiding direct eye pressure, optimizing hemodynamics, and minimizing surgical time is the most effective approach [8].

Other Considerations: Approximately one-third of adverse events after posterior lumbar fusion are diagnosed 31 to 90 days after surgery [1]. The peak period for unplanned hospital readmission after surgical treatment for thoracic spinal stenosis occurs from 10 to 40 days after surgery [12]. Lumbar disc surgery carries some risk of special complications, but the incidence of complications has not been excessively high [4]. Deep peroneal-nerve injury resulting from arthroscopic meniscectomy can result in persistent motor loss requiring surgical nerve grafting, with only partial recovery observed one year post-operatively [3]. Complication rates for transolecranon distal humerus fracture, including deep infection and nonunion, are high with frequent long-term functional limitations [6]. A review summarizes processes related to the diagnosis and treatment of complications after reverse shoulder arthroplasty to help clinicians reduce complications and perform appropriate procedures if they occur [7]. An erratum corrects data errors in a case series regarding delayed-onset neurological changes following posterior spinal fusion, updating the cohort size to 18 patients and revising ASIA scores and recovery descriptions [10]. Among patients who underwent multilevel cervical fusion, those with osteoporosis had a higher risk of adverse postoperative outcomes at two years [26]. Autonomic and non-autonomic dysfunction is common in long-term follow-up of cauda equina syndrome patients, even in those with the most optimistic prognosis [29]. Early decompression did not show a statistically significant correlation with improved outcomes in cauda equina syndrome patients [29]. The type of management for traumatic central cord syndrome did not significantly affect mortality, but age at the time of injury did [17]. Complications are common following limb salvage surgery for ankle sarcomas [16]. The timing of symptoms, imaging results, and the development of atypical symptoms can help distinguish Guillain-Barré syndrome from other postoperative spinal complications [2]. Understanding the current evidence and appropriate indications of emerging technologies in orthopaedic trauma is of critical importance for their utilization [35]. The beneficial effect of MIS THA on functional recovery needs proof [14].

Complications

Nerve palsy: Deep peroneal-nerve injury following arthroscopic meniscectomy can result in persistent motor loss requiring surgical nerve grafting, with only partial recovery observed one year post-operatively [3]. In posterior spinal fusion, delayed-onset neurological changes occur, with approximately one-third of adverse events diagnosed 31 to 90 days after surgery [1]. The timing of symptoms, imaging results, and the development of atypical symptoms help distinguish Guillain-Barré syndrome from other postoperative spinal complications [2]. Among patients undergoing multilevel cervical fusion, those with osteoporosis face a higher risk of adverse postoperative outcomes at two years [26].

Infection (PJI): Complication rates for transolecranon distal humerus fracture, including deep infection and nonunion, are high [6]. Disc-space infection and subsequent spontaneous interbody fusion following bowel perforation were followed by satisfactory recovery [19]. A dural tear secondary to operations on the lumbar spine does not appear to increase the risk of postoperative infection [24].

Wound complications: Surgical complications for lumbar disc herniation are less frequent than previously suggested [30]. Risk factors for complications following pediatric syndactyly release include operating on more than one web per surgery and undergoing more than one surgical event [37]. Overall complication rates were lower following arthroscopic approaches compared to open approaches in a cohort of surgeons performing elbow debridements [15].

Other Considerations: Perioperative vision loss is a rare but devastating complication with a poor prognosis and no proven effective treatment; prevention through strategies such as avoiding direct eye pressure, optimizing hemodynamics, and minimizing surgical time is the most effective approach [8]. The peak period for unplanned hospital readmission after surgical treatment for thoracic spinal stenosis occurs from 10 to 40 days after surgery [12]. Minimally invasive total hip arthroplasty (MIS THA) is a safe surgical procedure without increases in operative time, blood loss, operative complication rates, or component malposition rates, though the beneficial effect on functional recovery needs proof [14]. The presence of sublaminar implants in narrow, kyphotic segments likely exacerbated neural irritation by dural impingement [18]. An erratum corrected data errors in a case series regarding delayed-onset neurological changes following posterior spinal fusion, updating the cohort size to 18 patients and revising ASIA scores and recovery descriptions [10]. Lumbar disc surgery carries some risk of special complications of its own, yet the incidence of complications has not been excessively high [4]. Transolecranon distal humerus fracture poses frequent long-term functional limitations to the patient [6]. Further studies with long-term follow-up are needed to determine whether the grafted area in Autologous Matrix-Induced Chondrogenesis will maintain structural and functional integrity over time [21]. Health-related quality of life in early-onset-scoliosis patients treated with growth-friendly implants is influenced by etiology, complication rate, and ambulatory ability [23]. A dural tear secondary to operations on the lumbar spine does not appear to have any long-term deleterious effects, nor does it increase the risk of neural damage or arachnoiditis [24]. Despite major primary complications and a high incidence of radiographic signs of degenerative changes after 8.8 years, mainly good clinical results were achieved with Judet's bipolar prosthesis in bipolar radial head arthroplasty [38].

Recovery

Light activity (weeks): The timing of symptom onset and imaging results is critical for distinguishing specific complications, such as Guillain-Barré syndrome, from other postoperative spinal issues [2]. Approximately one-third of adverse events following posterior lumbar fusion are diagnosed between 31 and 90 days after surgery [1]. For thoracic spinal stenosis, the peak period for unplanned hospital readmission occurs from 10 to 40 days post-procedure [12].

Full activity (months): Functional outcomes for patients with spinopelvic dissociation remain significantly reduced one year after injury, with only one-third achieving pre-traumatic functional status at that time [5]. In contrast, patients with disc-space infection and subsequent spontaneous interbody fusion following bowel perforation have demonstrated satisfactory recovery [19]. For distal biceps tendon repair, most morbidity is attributed primarily to delays in the timing of the repair and secondarily to extensive anterior exposure [59].

Complete recovery / outcome plateau (months): One year following deep peroneal-nerve injury requiring surgical nerve grafting, only partial recovery is observed [3]. Long-term follow-up of cauda equina syndrome patients reveals that autonomic and non-autonomic dysfunction is common, even in those with the most optimistic prognosis, and early decompression does not correlate with improved long-term outcomes [29]. Five-year mortality after traumatic central cord syndrome is significantly affected by age at the time of injury, though the type of management does not significantly alter mortality rates [17].

Rehabilitation protocol: Close observation and medical management can effectively cause spontaneous regression of spinal epidural hematoma in patients presenting with mild neurological symptoms [32]. Perioperative vision loss carries a poor prognosis with no proven effective treatment; therefore, prevention through strategies such as avoiding direct eye pressure, optimizing hemodynamics, and minimizing surgical time is the most effective approach [8].

Functional milestones: Total resolution of spastic paraparesis followed resection of the hypertrophied fusion mass causing late paraparesis after scoliosis fusion, with no recurrence observed at four-year follow-up [27]. At two years after ACL reconstruction with tibialis anterior allografts, the subject group displayed satisfactory functional outcomes [39]. Complication rates for transolecranon distal humerus fracture, including deep infection and nonunion, are high and frequently pose long-term functional limitations to the patient [6].

Other Considerations: An erratum corrected data errors in a case series regarding delayed-onset neurological changes following posterior spinal fusion, updating the cohort size to 18 patients and revising ASIA scores and recovery descriptions [10]. The presence of sublaminar implants in narrow, kyphotic segments likely exacerbated neural irritation by dural impingement [18]. A dural tear secondary to operations on the lumbar spine does not appear to increase the risk of postoperative infection, neural damage, or arachnoiditis, nor does it appear to have any long-term deleterious effects [24]. Further studies with long-term follow-up are needed to determine whether the grafted area will maintain structural and functional integrity over time for mid-term results of Autologous Matrix-Induced Chondrogenesis [21].

Key Evidence

  • [L3] Approximately one-third of adverse events after posterior lumbar fusion were diagnosed 31 to 90 days after surgery, highlighting the importance of looking past the 30-day mark for adverse event characterization. (10.5435/jaaos-d-21-01121)
  • [L5] The timing of symptoms, imaging results, and the development of atypical symptoms can help distinguish this rare possibility from other postoperative spinal complications. (10.5435/jaaos-d-16-00572)
  • [Case_report] The injury resulted in persistent motor loss requiring surgical nerve grafting, with only partial recovery observed one year post-operatively. (10.2106/00004623-199308000-00012)
  • [L4] Lumbar disc surgery carries some risk of special complications of its own, but the incidence of complications has not been excessively high. (10.2106/00004623-196850020-00021)
  • [L3] For patients with spinopelvic dissociation functional outcomes are significantly reduced and only one-third of the patients achieved pre-traumatic functional outcomes 1 year after the injury. (10.1186/s12891-021-04676-w)
  • [L4] Complication rates, including deep infection and nonunion, are high, with frequent long-term functional limitations posed to the patient. (10.1016/j.jse.2020.07.012)
  • [L4] This review article summarizes the processes related to diagnosis and treatment of complications after reverse shoulder arthroplasty with the aim of helping clinicians reduce complications and perform appropriate procedures if/when complications occur. (10.5397/cise.2021.00066)
  • [L4] Perioperative vision loss is a rare but devastating complication with a poor prognosis and no proven effective treatment; therefore, prevention through strategies such as avoiding direct eye pressure, optimizing hemodynamics, and minimizing surgical time is the most effective approach. (10.5435/jaaos-d-15-00351)
  • [L4] A thorough understanding of the complications associated with anterior lumbar surgery will aid in prevention, recognition, and management of these rare problems. (10.5435/00124635-201105000-00002)
  • [L4] This erratum corrects data errors in the original case series regarding patient 9's hemodynamic and neurological outcomes, updating the cohort size to 18 patients and revising ASIA scores and recovery descriptions. (10.2106/jbjs.er.24.00164)
  • [L3] APF yielded superior sagittal alignment but was associated with higher early postoperative disability, most pronounced in segmental-type OPLL, though differences diminished by the second postoperative year. (10.1186/s13018-025-06504-6)
  • [L3] The peak period for readmission occurs from 10 to 40 days after surgery, suggesting the need for close follow-up during this interval. (10.1186/s12891-021-03975-6)
  • [L4] Adverse events associated with anterior cervical spine surgery are infrequent but can be serious and potentially life-threatening; appropriate strategies must be utilized to avoid these events, and surgeons must understand how to detect and manage them when they arise. (10.5435/00124635-200812000-00005)
  • [L1] MIS THA is a safe surgical procedure without increases in operative time, blood loss, operative complication rates and component malposition rates, though its beneficial effect on functional recovery needs proof. (10.1186/1471-2474-11-92)
  • [L3] Overall rates of complication were lower following arthroscopic approaches in this cohort of surgeons. (10.1177/23259671261425647)
  • [L3] Complications are common following limb salvage surgery for ankle sarcomas. (10.1302/0301-620x.103b3.bjj-2020-1308.r1)
  • [L3] The type of management did not significantly affect mortality but their age at the time of injury did. (10.1302/0301-620x.105b8.bjj-2022-1104.r2)
  • [L4] The presence of sublaminar implants in narrow, kyphotic segments likely exacerbated neural irritation by dural impingement. (10.2106/00004623-198668040-00012)
  • [L5] Symptomatic postoperative epidural hematomas and postoperative seromas are rare but potentially grave complications requiring thorough understanding of pathophysiology, meticulous clinical evaluation, and radiographic interpretation for appropriate management and optimal outcomes. (10.5435/jaaos-d-22-01022)
  • [L4] However, further studies with long-term follow-up are needed to determine whether the grafted area will maintain structural and functional integrity over time. (10.1007/s00167-010-1042-3)
  • [L4] Practice with the procedure and careful patient selection can lower the risk of complications. (10.1186/s13018-017-0691-z)
  • [L4] However, results were influenced by the etiology, complication rate or ambulatory ability. (10.1186/s12891-019-2969-2)
  • [L3] Such a tear does not appear to have any long-term deleterious effects or to increase the risk of postoperative infection, neural damage, or arachnoiditis. (10.2106/00004623-199812000-00002)
  • [L4] Despite these complications, the treatment can be completed successfully with careful planning and meticulous attention to detail. (10.2106/00004623-199509000-00013)
  • [L3] Among patients who underwent multilevel cervical fusion, those with osteoporosis had higher risk of adverse postoperative outcomes at two years. (10.5435/jaaos-d-22-00361)
  • [Case_report] Total resolution of spastic paraparesis followed resection of the hypertrophied fusion mass, with no recurrence observed at four-year follow-up. (10.2106/00004623-198163060-00023)
  • [L4] Once diagnosed, the spinal instrumentation must be removed, the wound debrided, and primary closure performed. (10.2106/00004623-199504000-00004)
  • [L3] Autonomic and non-autonomic dysfunction is common in long-term follow-up of cauda equina syndrome patients, even in those with the most optimistic prognosis, and early decompression did not show a statistically significant correlation with improved outcomes. (10.1302/0301-620x.103b9.bjj-2021-1152)
  • [L3] The results suggest that surgical complications are less frequent than previously suggested. (10.1302/0301-620x.101b4.bjj-2018-1184.r1)
  • [L5] Management of heterotopic ossification is aimed at limiting its progression and maximizing function of the affected joint. (10.5435/00124635-200911000-00003)
  • [L4] Close observation and medical management can be an effective way to cause spontaneous regression of spinal epidural hematoma in patients presenting with mild neurological symptoms. (10.1186/s12891-023-06428-4)
  • [L4] The main complications of surgery were postoperative aggravated kyphosis and adjacent kyphosis deformity. (10.1186/s13018-015-0300-y)
  • [L5] The goals of therapy include eradicating the infection, relieving pain, preserving or restoring neurologic function, improving nutrition, and maintaining spinal stability. (10.5435/00124635-200806000-00005)
  • [Case_report] This case underscores the diagnostic challenges and delayed presentation of esophageal perforation post-ACSS. (10.1530/eor-24-0110)
  • [L4] Risk factors for complications following syndactyly release include >1 web operated on per surgery and undergoing >1 surgical event. (10.1016/j.jhsa.2022.10.017)
  • [L4] Despite major primary complications and high incidence of radiographic signs of degenerative changes after 8.8 years, mainly good clinical results were achieved with Judet's bipolar prosthesis. (10.1016/j.jse.2010.05.022)
  • [L4] At 2 years after ACL reconstruction with tibialis anterior allografts, this subject group displayed satisfactory functional outcomes. (10.1007/s00167-003-0371-x)
  • [L3] Stratification based on central neuromotor impairments can help to identify patients with cerebral palsy at GMFCS level 5 who are at higher risk for developing complications after spinal arthrodesis. (10.2106/jbjs.15.01359)
  • [L3] This procedure can improve patients' pain, neurological function and kyphotic deformity and achieve effects similar to traditional methods, making it an ideal surgical treatment for thoracolumbar fractures in AS patients. (10.1186/s13018-022-03378-w)
  • [L4] The authors advise that patients undergoing lumbar decompressive surgery should have sagittal whole spine MRI studies pre-operatively to exclude proximal neurological compression. (10.1302/0301-620x.95b10.31222)
  • [L1] More severe pain immediately after surgery did not result in a higher incidence of chronic pain in the no drain group compared with the drain group. (10.1302/0301-620x.106b10.bjj-2024-0460.r1)
  • [L4] However, return to the operating room for MUA is similar to other graft types. (10.1177/23259671251364255)
  • [L4] Preoperative planning to accurately select and insert pedicle screws in adolescent idiopathic scoliosis should be based on anatomical limitations in the apical vertebra region, apical vertebra level, and apical vertebral rotation degree. (10.1186/s12891-022-05799-4)
  • [L4] Closed subarachnoid drainage is a reasonably effective and safe method for treating dural-cutaneous cerebrospinal-fluid leaks after a spinal operation and may be considered a non-operative alternative to reoperation and direct repair of the dura. (10.2106/00004623-198971070-00004)
  • [L3] Change in Cobb angle is an independent risk factor for minor perioperative complications, while both change in Cobb angle and spinal osteotomy are independent risk factors for major perioperative complications. (10.1186/s12891-021-04361-y)
  • [L3] The study identified various imaging changes after Coflex implantation, most of which did not affect clinical outcomes. (10.1186/s12891-023-06798-9)
  • [L3] Mono-segment fixation is more suitable for the treatment of single-segment LSTB because the lumbar segments with normal motion can be preserved with less trauma, a shorter operation time, shorter hospitalization, and lower costs. (10.1186/s12891-020-3115-x)
  • [L3] This study underscores the importance of preoperative screening and optimization of patients before spinal surgery to identify and address low BMD preoperatively to improve postoperative outcomes. (10.5435/jaaos-d-21-01258)
  • [L3] Subsequent vertebral body fractures occurred in 19.2% of patients and were significantly associated with higher pain levels and worse ODI scores. (10.1186/s12891-022-06031-z)
  • [L3] A DiffVMVA ≤ +10° clearly identifies bony bridging of the posterior elements of a non-mobile LSTV and hence the first adjacent mobile segment. (10.1302/0301-620x.95b11.32331)
  • [L4] However, magnetic resonance imaging indicates that the donor site is resurfaced with fibrous tissue. (10.1177/0363546507306465)
  • [L4] Therefore, there is no need for additional training to improve postural control in these adolescents with idiopathic scoliosis. (10.1186/s12891-024-08210-6)
  • [L3] Heart disease presents an additional challenge to spine fusion patients who are undergoing a challenging and risky procedure. (10.5435/jaaos-d-21-00850)
  • [L4] Most morbidity from repair of the distal biceps tendon can be attributed primarily to a delay in the timing of the repair and secondarily to an extensive anterior exposure. (10.2106/00004623-200011000-00010)

See Also

References

[1] Adverse Events After Posterior Lumbar Fusion Are Not Sufficiently Characterized With 30-day Follow-up: A Database Study. Journal of the American Academy of Orthopaedic Surgeons. 2022. DOI: 10.5435/jaaos-d-21-01121

[2] Guillain-Barré Syndrome After Elective Spinal Surgery. Journal of the American Academy of Orthopaedic Surgeons. 2017. DOI: 10.5435/jaaos-d-16-00572

[3] Deep peroneal-nerve injury as a result of arthroscopic meniscectomy. A case report and review of the literature.. The Journal of Bone & Joint Surgery. 1993. DOI: 10.2106/00004623-199308000-00012

[4] Local Complications. The Journal of Bone & Joint Surgery. 1968. DOI: 10.2106/00004623-196850020-00021

[5] Functional outcomes and quality of life after surgical treatment of spinopelvic dissociation: a case series with one-year follow-up. BMC Musculoskeletal Disorders. 2021. DOI: 10.1186/s12891-021-04676-w

[6] Complications and functional outcomes after transolecranon distal humerus fracture. Journal of Shoulder and Elbow Surgery. 2021. DOI: 10.1016/j.jse.2020.07.012

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[10] Erratum: Delayed-Onset Neurological Changes Following Posterior Spinal Fusion. Journal of Bone and Joint Surgery. 2025. DOI: 10.2106/jbjs.er.24.00164

[11] Functional recovery after laminoplasty versus staged anterior–posterior fusion for multilevel cervical ossification of the posterior longitudinal ligament. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06504-6

[12] Unplanned hospital readmission after surgical treatment for thoracic spinal stenosis: incidence and causative factors. BMC Musculoskeletal Disorders. 2021. DOI: 10.1186/s12891-021-03975-6

[13] Adverse Events Associated With Anterior Cervical Spine Surgery. Journal of the American Academy of Orthopaedic Surgeons. 2008. DOI: 10.5435/00124635-200812000-00005

[14] Minimally invasive and computer-navigated total hip arthroplasty: a qualitative and systematic review of the literature. BMC Musculoskeletal Disorders. 2010. DOI: 10.1186/1471-2474-11-92

[15] Arthroscopic Versus Open Elbow Debridements Among ABOS Part II Candidates: A Decline in Arthroscopic Volume yet Fewer Complications After Arthroscopic Procedures. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671261425647

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[21] Mid‐term results of Autologous Matrix‐Induced Chondrogenesis for treatment of focal cartilage defects in the knee. Knee Surgery, Sports Traumatology, Arthroscopy. 2010. DOI: 10.1007/s00167-010-1042-3

[22] Complications of lumbar disc herniations following trans-sacral epiduroscopic lumbar decompression: a single-center, retrospective study. Journal of Orthopaedic Surgery and Research. 2017. DOI: 10.1186/s13018-017-0691-z

[23] Health-related quality of life in early-onset-scoliosis patients treated with growth-friendly implants is influenced by etiology, complication rate and ambulatory ability. BMC Musculoskeletal Disorders. 2019. DOI: 10.1186/s12891-019-2969-2

[24] Dural Tears Secondary to Operations on the Lumbar Spine. Management and Results After a Two-Year-Minimum Follow-up of Eighty-eight Patients. The Journal of Bone & Joint Surgery*. 1998. DOI: 10.2106/00004623-199812000-00002

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[32] Screw fixation without fusion for low lumbar chance fracture accompanied by spinal epidural hematoma in patient with ankylosing spondylitis. BMC Musculoskeletal Disorders. 2023. DOI: 10.1186/s12891-023-06428-4

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[38] Mid- to long-term results after bipolar radial head arthroplasty. Journal of Shoulder and Elbow Surgery. 2010. DOI: 10.1016/j.jse.2010.05.022

[39] Two‐year outcomes following ACL reconstruction with allograft tibialis anterior tendons: a retrospective study. Knee Surgery, Sports Traumatology, Arthroscopy. 2003. DOI: 10.1007/s00167-003-0371-x

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