Medical Malpractice Litigation in Spine Surgery: A Systematic Review

Area of Science:

• Medical Law
• Surgical Outcomes
• Patient Safety

Background:

• Spine surgery carries a high risk of litigation, with most surgeons facing malpractice claims.
• Understanding litigation trends is crucial for improving patient care and reducing legal risks.

Purpose of the Study:

• To systematically review and analyze the trends and characteristics of medical malpractice claims following spine surgery.
• To identify common reasons for litigation, patient injuries, and outcomes of legal cases in spine surgery.

Main Methods:

• Systematic literature search across major databases (PubMed, Scopus, Embase, Web of Science).
• Inclusion of studies with original data on spine surgery litigation, regardless of date or geography.
• Extraction of data on demographics, diagnoses, procedures, verdicts, reasons for claims, injuries, and payouts.

Main Results:

• Analysis of 5,514 malpractice cases from 54 studies (1968-2023).
• Most common litigation reasons: delayed diagnosis/treatment, intraoperative errors, and inadequate informed consent.
• Frequent injuries: new neurological deficits, persistent pain, and need for additional surgery. Defense verdicts were most common.

Conclusions:

• New neurological deficits, often linked to diagnostic delays or procedural errors, are primary drivers of spine surgery litigation.
• Enhanced patient communication and informed consent are vital for improving care and mitigating malpractice claims.