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[Complaints regarding lumbar disk herniation treatment reported to the Norwegian Compensation System]
Ingjald Bjerkreim1, Harald Steen
1Norsk Pasientskadeerstatning Postboks 1733 Vika 0121 Oslo. ingjald.bjerkreim@rikshospitalet.no
Background, Material And Methods:
Over the 1993-99 period the Norwegian Patient Compensation System made decisions in 4,041 orthopaedic treatment injury cases. 700 cases were randomly selected and analysed in order to elucidate the reasons for complaints. 58 cases were related to lumbar disc herniation treatment.
Results:
Of these 58 cases, 52 complaints were lodged against hospitals; six against primary health care providers. Seven patients had been primarily observed or non-operatively treated; 55 were eventually operated on, eight with recurrent disease. Nearly all complaints were related to the outcome of surgery (72%) and delay of diagnosis/surgery (21%). Several serious complications occurred; one patient died. Five patients had cauda equina syndrome; a further seven had neurological deficits from distal spinal nerve roots. In 17 cases (29%) the complaints were accepted, while 41 complaints (71%) were rejected.
Interpretation:
In lumbar disc herniations both surgery, observation and non-operative treatment may lead to severe complications. It is important to select the right patients for surgery and to provide good information.