Operative risks include infection, bleeding, neurological injury, instability, dural tear.

Post-operative infection rates for all surgical procedures performed vary on a national basis between 1 and 2%. We have experienced an infection rate of less .5% with respect to multiple level lumbar decompressive procedures.

Bleeding associated with lumbar decompression is usually minimal. Although the potential exists for greater blood loss in multiple level procedures there have been no cased requiring blood transfusion.

Neurological injury is an unlikely operative complication. The exact incidence of permanent neurological injury is unknown although it is probably on the order of less than 1%. Most frequently, post-operative neurological deficits were present pre-operatively. Occasionally, transient weakness or sensory change may be noted post-operatively due to traction, compression, or swelling of affected nerve roots. These conditions are typically temporary and usually resolve in a matter of days or weeks. Transient paraparesis (weakness of lower extremities) developed in one case post-operatively and gradually recovered.

10 patients (4.7%) have undergone re-operation for problems related to the initial procedure. Five of these patients (2.3%) required fusion including instability in four and as a result of infection in one. Four patients (1.9%) required repeat decompression for persistent symptoms following their initial procedure. One patient (.5%) underwent re-exploration and repair of a persistent CSF leakage following a dural tear during the initial procedure.

Eight patients (3.7%) required subsequent decompression procedures for new onset symptoms at other levels after successful initial treatment.