The Importance of Lumbar Surgery Follow Up

The Importance of Lumbar Surgery Follow Up

Lumbar Surgery is surgery to the lumbar spine and adjacent levels including T12 and S1. Lumbar surgery is performed for a variety of indications, usually degenerative disease-causing nerve root entrapment, leg pain, pins and needs and numbness. Lumbar Spine Surgery has an extensive number of risks associated with it. These include damage to the nerves, bleeding, infection, CSF leak, ongoing pain and cage failure.

Due to the extensive number of risks associated with such a significant procedure, it is important that appropriate follow up is provided to a patient who undertakes this. The usual, and reasonable, follow up for lumbar surgery is a routine clinical follow up during the admission and a minimum of once in the clinic after surgery

It is expected that patients are seen in hospitals every day by the consultant in charge of their care or a colleague. In general, the time frame for follow up and review should be commensurate with the condition of the patient. If a patient has uncomplicated surgery and can go home the next day, then they may have a medical review not until outpatients. If the patient has a complication of the surgery and needs clinical examination, they should be seen directly after the surgery on waking.

The biggest risk of lack of follow up is patient dissatisfaction. If a patient has a medically serious problem: neurological deficit or infection, then it should be brought to the attention of the nurse looking after them as an inpatient or they should re-present to the outpatient service. However not seeing a patient during their inpatient stay means that the patient is not given the chance to be informed in their care, raise their concerns with the treating surgeon, and be properly evaluated to enable ongoing consideration of their symptoms and consideration of the effectiveness of their care.

In summary, it is imperative that following Lumbar Surgery, appropriate follow up is provided so as to ensure the patient involved remains informed and consistently evaluated.

References

  • Co-written by The TMLEP Clinical Risk and Patient Safety Publishing Group, Ms Georgia Millington, Divisional Lead Analyst at TMLEP and Mr Matthew Crocker, Consultant Neurosurgeon. (2021). The Importance of Lumbar Surgery Follow Up. TMLEP Clinical Risk Case Studies. 7 (4), 1.

Important Note

This article is intended to raise awareness to clinical risk issues in an effort to reduce incidence recurrence and improve patient safety. This is not intended to be relied upon as advice. Facts have been altered to ensure this case is non-identifiable, albeit clinical learning points remain applicable. To request an independent clinical review, please contact admin@tmlep.com or call +44 (0) 203 355 9796.