Injury and Liability Associated With Spine Surgery

Area of Science:

• Anesthesiology
• Neurosurgery
• Spine Surgery

Background:

• Spine surgery carries significant morbidity, but anesthesia-related liability is not well-defined.
• Anesthesia Closed Claims Project database was utilized to investigate spine procedure claims.

Purpose of the Study:

• To evaluate anesthesia liability profiles and injury patterns in spine surgery.
• To identify factors associated with permanent disabling injuries during spine procedures.

Main Methods:

• Retrospective cohort study of anesthesia claims from 2000-2014.
• Comparison of injury mechanisms between cervical and thoracic/lumbar spine procedures.
• Logistic regression analysis to identify risk factors for permanent disabling injury.

Main Results:

• Spine procedure claims represented over 10% of all claims, with 207 cases analyzed.
• Permanent disabling injuries (nerve, spinal cord, eye) were more frequent in spine surgery.
• Prone positioning and surgical duration of ≥4 hours significantly increased the odds of severe permanent injury.

Conclusions:

• Anesthesia claims in spine surgery are linked to severe permanent disability, particularly nerve and eye injuries.
• Prone positioning and extended surgical duration are key risk factors for permanent injury.
• Strategies to mitigate risk include careful patient positioning, managing blood loss, and shortening surgery length.