Classification and management of early complications in open lumbar microdiscectomy.
Complications and side effects in any kind of surgery, especially in spine surgery, should be evaluated to prevent those problems in the future. Since retrospective studies are of minor value and randomized controlled studies for complications are impossible to perform because of ethical and legal reasons, so-called "expert opinion" has to take their place in evidence-based medicine. On the basis of an analysis of the results of three spine centers together with the opinions of experienced spine surgeons, the authors have drawn up a classification of complications in open lumbar disc surgery and recommendations on how to manage common complications such as excessive bleeding, dural opening, nerve root lesions and recurrent disc herniation. The management of intraoperative complications should have the same training in microdiscectomy instructional courses as the operation itself.
Kraemer
Robert
R
Department of Orthopedics, Heinrich-Heine University Hospital Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany. KraemerRo@med.uni-duesseldorf.de
Wild
Alexander
A
Haak
Holger
H
Herdmann
Jörg
J
Krauspe
Rüdiger
R
Kraemer
Jürgen
J
D017586:Diskectomy / Q000009:adverse effects*; D006801:Humans; D017053:Infection Control; D007403:Intervertebral Disc / Q000473:pathology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D007431:Intraoperative Complications / Q000145:classification* / Q000517:prevention & control / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection; D011182:Postoperative Care; D011183:Postoperative Complications / Q000145:classification* / Q000517:prevention & control / Q000628:therapy*; D013997:Time Factors