Complications

The feared complication after intramedullary spinal cord surgery is paralysis. Surprisingly the risk of complete paralysis after spinal cord surgery today is quite low (under 5 %). The likelihood of significant neurological dysfunction after surgery is primarily related to the preoperative neurological condition: someone who is normal or near normal neurologically before surgery has an excellent chance of coming through the surgery with a good resection (i.e. > 80%) and little change in neurological function. However, when more significant neurological deficits are present before surgery, there is a higher the risk of deterioration in function after surgery. Furthermore, it is unlikely to recover function which has been lost prior to surgery.

For neurological recovery almost everyone needs physical therapy to some degree, either for only a short time, or for a more prolonged period on an outpatient basis. Occasionally, more intensive therapy as an inpatient in a rehabilitation facility is indicated.

Other complications of spinal cord tumor surgery may include leakage of cerebrospinal fluid through the incision. This is something that we have seen particularly in patient who underwent radiation at some point prior to surgery. Infection and postoperative hemorrhage fortunately are very rare.

Over the long term after surgery, particularly when the operative approach involved many vertebral levels of the spine there is a risk of progressive spinal deformity. This requires vigilance with clinical examinations and X-rays in regular intervals and if necessary the involvement of a spinal orthopedic surgeon.

Meghan D. Kelly, MS, CCLS