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 needles 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 followed by a minimum of once in the clinic post-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 timeframe 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 the medical review may be delatyed until their next outpatient appointment. If the patient has a complication of the surgery and needs clinical examination, they should be seen directly post-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 in order 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.