While it is very rare to experience complications after spinal surgery, it is important to be aware of them nonetheless. This page lists signs of possible complications, including infection and stomach problems.
Infection
Infection can be either superficial or deep. A superficial infection after spine surgery would occur around the surgical incision. A deep infection after spine surgery would happen in the spinal column.
The risk of infection after spine surgery is about 2%. Infection can show up early, meaning within the first few weeks of surgery. Infection can also occur late, meaning up to two to three years after surgery.
Signs of infection include:
- Warmth around the incision area
- Increased body temperature (greater than 38.5°C or higher)
- Redness around the incision area
- Swelling around the incision area
- Pus or excessive drainage from the incision area
- Increased pain
Infections are treated with dressing changes and antibiotics. Sometimes surgery is required to clean out the infected tissue. Infection can sometimes result in loss of fixation. This means that the spine doesn’t heal in a straightened position.
Stomach problems
Ileus
Spinal surgery can cause ileus, where the intestines stop contracting and may become blocked. The risk of ileus after spine surgery is about 2%.
Signs of ileus include:
- Abdominal cramping
- Distension: when the abdomen becomes swollen
- Nausea
- Vomiting
If your teen develops ileus, they will not be able to take food or water by mouth. They will be given fluids through IV (intravenous needle). Or they may be given fluids through a feeding tube inserted through their nose into their stomach. A tube might be inserted into their stomach to drain any excess fluids. Ileus generally gets better in five to 10 days.
Superior mesenteric artery syndrome (SMA)
There is a large artery running from the heart to the intestines, called the superior mesenteric artery (SMA). Sometimes after spinal surgery, the small intestine can become blocked by pressure from the SMA. This is called SMA syndrome.
The risk of SMA is about 3%. Underweight females tend to be more at risk. Signs of SMA syndrome are more severe than in ileus and tend to last longer.
Signs of SMA include:
- Nausea
- Vomiting, usually projectile vomiting of green secretions
- Pain
Treatment includes a feeding tube for liquid nutrition. The feeding tube runs through the nose and into the stomach. Another tube is placed in the intestine to drain fluids. SMA syndrome can last from one to two months. Body weight and eating patterns may not return to normal for several months.
Neurological complications
Neurological complications are complications that affect the nervous system, meaning the brain, spinal cord, or nerves. The risk of neurological complications ranges from 1% to 4%. Neurological complications can occur for a variety of reasons:
- Swelling in the spinal cord
- Pressure from the surgical table. When your teen is placed on their stomach for surgery, there are several pads and bolsters that support their body from underneath. Because your teen will be in this position for many hours, this may put pressure on the front of their thighs which can lead to irritation of the "feeling” nerves in their thighs. Your teen may experience numbness on the front of their thighs. This usually goes away after one to two years.
- Tension on the spinal cord
- Other unknown reasons
Signs of neurological complications include:
- Loss of skin sensation
- Weakness or loss of strength in the legs and feet
- Paralysis in the legs and feet
- Loss of bowel and bladder control
Treatment may include steroid medication to reduce spinal cord swelling, removal of hardware, or watchful waiting. Neurological complications can improve over time, but some may be permanent. Physiotherapy and rehabilitation may be necessary to strengthen muscles if a neurological complication occurs.