A Closer Look at Lumbar Spinal Surgical Errors and the Consequences
Any surgery has the chance for mess-ups. Â Some of these mistakes can be more detrimental than others. A âsentinel eventâ is the worst kind of mistake-- mistakes that could be avoided that result in death, the risk of death, physical or psychological injury. Â 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. Â
Researchers tapped into a national database that approximately represents 20 per cent of all patients sent home from U.S. hospitals. Â 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. Â 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. Â
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. Â Sentinel events are avoidable and if they do occur procedures should immediately be mitigated to prevent future occurrence.
Alejandro Marquez-Lara, MD et al. Sentinel Events in Lumbar Spine Surgery. Spine Journal. May, 2014. Vol. 39, No. 11. Pp 900-905.