Complications in Spinal Surgery: A Comprehensive Guide is a comprehensive reference for before and after surgery, covering common complications and rare complexities. The book is divided into major sections, including safety in spine surgery, general complications, complications by region (cervical, thoracic, lumbar, and sacral), complications related to pediatrics, and predictive analytics. Although some complications can happen irrespective of the spinal region, dividing into anatomical sections make the most sense for the reader. Designed to benefit both surgeons-in-training-residents and fellows-and seasoned professionals in orthopedic and neurosurgical spine practice, this book provides critical insights into the prevention, recognition, and management of complications.
Unique to this book are the other implications of complications, such as how to approach patients and families, the medicolegal aspects of complications, and how to deal with these situations at a personal level. With its evidence-based approach, real-world case discussions, and expert perspectives, it equips readers with the knowledge and confidence to navigate the complexities of spine surgery and improve patient outcomes.
Unique to this book are the other implications of complications, such as how to approach patients and families, the medicolegal aspects of complications, and how to deal with these situations at a personal level. With its evidence-based approach, real-world case discussions, and expert perspectives, it equips readers with the knowledge and confidence to navigate the complexities of spine surgery and improve patient outcomes.
Table of Contents
Part 1. Safety in Spine Surgery1. Defining and classifying complications in spine surgery
2. Medicolegal implications of complications in spine surgery
3. The psychology of failure
4. Approaching patients and families
5. Best practice guidelines and checklists
6. Preoperative planning in general and complex spinal surgery
7. Antibiotic therapy in spine surgery
8. Anesthetic considerations in spine surgery
9. Intraoperative neuromonitoring
10. Intraoperative navigation setup and failures
11. Robotic spine surgery setup and failures
Part 2. General Complications
12. Complications related to prone positioning
13. Complications related to lateral positioning
14. Massive blood loss
15. The osteoporotic spine
16. Wrong level and wrong side surgery
17. Retention of foreign bodies
Part 3. Cervical Spine
18. Postoperative dysphagia
19. Vertebral artery injury
20. Esophageal injury
21. Thoracic duct injury
22. Recurrent laryngeal nerve palsy
23. Horner’s syndrome
24. Spinal Cord Injury
25. Cervical durotomy and pseudomeningocele
26. Hypoglossal nerve palsy
27. Acute anterior implant extrusion and failure
28. Acute posterior implant extrusion and failure
29. Soft tissue and epidural hematoma
30. Anterior cervical infection
31. Misplaced cervical screws
32. C5 palsy
33. Adjacent segment disease
34. Proximal junctional kyphosis and failure in the cervical spine
35. Laminoplasty failure
36. Disc replacement failure
Part 4. Thoracolumbar Spine
37. Thoracic or lumbar screw misplacement
38. Complications in robotic-assisted screw placement
39. Loss of motor signals during deformity surgery
40. Pseudoarthrosis
41. Venous injury (vena cava, iliac)
42. Arterial injury (aorta, iliac)
43. Lung injury
44. Bowel injury
45. Ureter injury
46. Proximal junctional kyphosis and failure in the thoracolumbar spine
47. Incidental durotomy, pseudomeningocele, and postoperative CSF leak
48. Incidental durotomy during tubular or endoscopic spine surgery
49. Postoperative deep/organ space infection
50. Postoperative wound infection prevention and risk management
51. Screw osteolysis in severe infection
52. Perioperative visual loss
53. Disc replacement failure
54. Cement extravasation
Part 5. Sacrum
55. Insufficiency fractures after sacrectomy for primary tumors
56. Insufficiency fractures after long-segment instrumentation
57. S2AI screw loosening
58. Pelvic screw failure
59. Sacroiliac joint pain after instrumentation
60. Rectal injury
Part 6. Pediatric Spine
61. Halo gravity traction complications
62. Neuromonitoring signal changes during deformity correction
Part 7. Complication Prediction
63. Patient risk factors for perioperative complications
64. Logistic regression models to predict complications
65. Artificial intelligence and machine learning to predict complications
Authors
Rafael De la Garza Ramos Spine Surgeon and Asst Professor, Neurosurgery, Montefiore Medical Center, New York, NY, USA. Dr. Rafael De La Garza Ramos, MD, was born and raised in Monterrey, Mexico. He received his medical degree from the Monterrey Institute of Technology and Higher Education, graduating with honors. He later completed a three-year research fellowship at Johns Hopkins University School of Medicine within the Department of Neurosurgery. During this time, he received an A. Earl Walker Outstanding International Fellow Award for his contributions to the advancement of neurological sciences. He is currently is currently a Spine Surgeon and Director of Spine Research at Montefiore Health System, Assistant Professor of Neurosurgery at Albert Einstein College of Medicine, and Neurosurgeon at Montefiore Medical Center Albert Einstein College of Medicine, in New York. Reza Yassari Professor, Neurosurgery and Orthopedics, Montefiore Medical Center, Bronx, NY, USA.Dr. Yassari earned his medical degree from the Medical University of Vienna in Austria with a dissertation in neuropathology. He completed his basic surgical training in England, before relocating to the United States, where he received a Master of Science degree in experimental pathology at the University of Chicago. He completed his residency in neurosurgery at the University of Chicago Hospital. He underwent fellowship training in spinal oncology and reconstructive and complex spine surgery at the Johns Hopkins University School of Medicine and started his tenure as Assistant Professor of Neurological Surgery at Montefiore and Albert Einstein College of Medicine and became Professor of Neurological Surgery in 2018. Dr. Yassari is board certified by the American Board of Neurological Surgery and a Fellow of the American College of Surgeons.
Ziya Gokaslan MD Professor and Chair, Dept of Neurosurgery, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA. Ziya L. Gokaslan is the Julius Stoll, MD Professor and Chair of the Department of Neurosurgery at The Warren Alpert Medical School of Brown University. He serves as the Neurosurgeon-in-Chief at Rhode Island Hospital and The Miriam Hospital. Dr. Gokaslan is also the Clinical Director of the Norman Prince Neurosciences Institute. Furthermore, he leads the Norman Prince Spine Institute at Brown University Health and is Director of the Complex Spinal Surgery Fellowship at The Warren Alpert Medical School of Brown University. He's the recipient of numerous prestigious awards, including the Leon Wiltse Award recognizing his excellence in leadership and clinical research in spine care by North American Spine Society, and is an active member of many professional societies including American Academy of Neurosurgeons, World Academy of Neurosurgeons, and The Society of Neurological Surgeons. He also served as Chairman of AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves.
