The goal of spinal decompression is to alleviate pressure on the spinal cord or its spinal nerves. As theses tissues are compressed, they undergo pathological changes which results in symptoms such as pain and weakness. Procedures for spinal decompression include either surgical or nonsurgical techniques. The surgical procedures carry the risks, however, which is why in some cases nonsurgical spinal decompression therapy is an attractive first option.
Impaired Sensory and Motor Function
Spinal decompression surgery is very delicate because it involves manipulating tissues on or very near the spinal cord. Because of this close proximity, spinal decompression surgery can result in inadvertent damage to these neural tissues by the surgeon. According to the National Institutes of Arthritis and Musculoskeletal and Skin Diseases, the most common risk of decompressive surgery is tearing the membrane covering the spinal cord and nerve roots. This may cause leakage of cerebrospinal fluid which can result in neurological impairment. The neural tissue also can be damaged directly by piercing with sharp instruments, abrasion during bone removal or by compression of nerve roots with prolonged retraction. Any of these can jeopardize the integrity of the spinal cord or spinal nerve roots. Once the nervous tissue is damaged, impairment of sensory or motor function may result.
Stabilization and Fusion Failure
Often, the surgeon will use screws or rods to stabilize vertebrae or to encourage vertebrae to fuse. According to the Mayfield Clinic, however, there is a risk that such hardware may fail to stabilize the vertebrae or that fusion may not occur. In either case, unstable vertebrae can result in damage to the spinal cord or the spinal nerves. The hardware also may fracture the vertebrae either during surgery or afterward, particularly when the patient attempts rehabilitation. Under any of these circumstances another surgery may be necessary to repair the problem.
Tissue Damage
With decompressive surgery there are risks of damage to other tissues. According to the Merck Manuals Online Medical Library, bleeding at the surgical site is one of them. Often, the bleeding is not apparent until the surgical site is closed. If the bleeding is severe enough, another surgery may be required to repair or seal damaged blood vessels. Blood clots also can result from general surgery. Clots begin to form at the surgical site and migrate, becoming a deep vein thrombosis, or DVT. This is dangerous because of the resulting tissue damage that may occur if the blood clot travels to the lungs or brain. Anticoagulant drugs such as aspirin and Heparin can be given to manage blood clots. Infection also can severely damage tissues after surgery. The infection can be localized to the surgical site or can be systemic. Infections are usually treated effectively with oral or intravenous antibiotic drugs.
Other Risks
Poor outcome is an associated risk of spinal decompression surgery. It is not uncommon for the surgical procedure to fail to relieve symptoms for any number of reasons. Sometimes spinal decompression surgery may appear as though it is successful, but in time the symptoms return. In these instances, the doctor and patient need to reassess the risks and benefits of another surgery.
