A Closer Look at Lumbar Spinal Surgical Errors and the Consequences

Any surgery has the chance for mess-ups.  Some of these mistakes can be more detrimental than others. A “sentinel event” is the worst kind of mistake– mistakes that could be avoided that result in death, the risk of death, physical or psychological injury.  A recent study took a closer look at the prevalence, type of surgery error, and the overall results of these sentinel events in regards to lumbar spinal surgery.  

Researchers tapped into a national database that approximately represents 20 per cent of all patients sent home from U.S. hospitals.  It looked at a window from 2002 to 2011 and identified all patients who had a lumbar spine surgery, eliminating patients younger than 18 and only using data of patients who were admitted for degenerative conditions, with a total of 543,146 lumbar spine surgeries identified. They then flagged sentinel events occurring in this population, totaling 414.  Of these, 30 were bowel or peritoneal injuries (i.e. puncture), 82 were vascular injuries (i.e. cutting a vein or artery), 108 were nerve injuries, 54 were foreign objects left inside, and 142 were wrong-sided surgeries.

Some specific surgeries were found more likely to have errors associated with them. With a posterior (back) approach the risk for wrong-sided surgery increased and with an anterior (front) approach the risk for peritoneal, vascular or bowel injuries increased. The chance of death in correlation to a sentinel event for this population was found to be 20 times greater than in patients not having a sentinel event and the possibility of a further post surgical complication like a blood clot or heart problems significantly increased.  

Authors concluded that patients who had a sentinel event had longer hospital stays and incurred more costs and have overall poorer outcomes following a lumbar spinal surgery.  Sentinel events are avoidable and if they do occur procedures should immediately be mitigated to prevent future occurrence.