Spinal SurgerySurgical Treatment provided by Spinal Surgeon Mr David Chapple
Every patient is asked to sign a consent form prior to any procedure or operation. This would be following a full and detailed discussion about the risks and complications of the procedure for that patient. This discussion may occur during a consultation session to allow reflection by the patient on the information given about the procedure or operation. Mr Chapple fully respects patients' autonomy - their right to decide whether or not to undergo any medical intervention. The patient will have a discussion concerning the natural history (what could happen if no treatment is undertaken). The alternative procedures or operative interventions will also be discussed if appropriate. This is done in accordance with GMC guidelines for Good Medical Practice.
Complications are events that have a chance of happening after any procedure. There are no procedures or operations without risks. Every effort is made to reduce the chance if complications occurring. If a patient has a pre-existing medical condition it can change the chance of complications occurring. For this reason it is crucial that patients give a full past medical history and details of all medication, prescribed and non prescribed that they are taking. This should include details of all herbal medicines and supplements. If the patient can bring a list of their current medications and any known allergies to medications this would be very helpful. Details of current other medical conditions or past illnesses will be asked for during the consultation and any details the patient is unclear on then clarification should be sort from their general practitioner. If the procedure requires a general anaesthetic there are general complication risks:
• DEEP VEIN THROMBOSIS-DVT These are caused by clots of blood forming in the legs – DVT- which may dislodge and travel to the lungs – PE. The process can on very rare occasions be fatal. The rates of thrombo-embolism after spinal surgery are low as patients are given a variety of risk reduction agents. They may be prescribed blood thinning agents, TED stockings, calf pumps and patients are encouraged to mobilize rapidly after surgery. The risks of VTE will always be discussed pre-operatively in detail.
This is a complication which can occur after any procedure making a wound in the skin. Rates of infection are low after spinal surgery at less than 1%. Surgery requiring placement of metal work has a slightly increased rate of 2- 5%. Appropriate antibiotics are given to patients at surgery and afterwards to reduce risk. All patients for inpatient stays are swabbed at pre-admission for MRSA. In the event of a positive result for MRSA the patient will be contacted and action set in place to eradicate MRSA before admission can take place. This may require liaison with the patient’s GP and the microbiology consultant. New Hall Hospital and Salisbury Hospital NHS Trust have an MRSA policy.
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