Negligent Placement of Spinal Implant Injures Patient

Case Overview

This case takes place in Tennessee and involves a patient with a past medical history of leg pain following a back injury. She underwent a spinal fusion and decompression in an attempt to alleviate her pain, however, after the procedure her pain had increased, and had spread from its original location to include a larger part of the leg. Several months later, she saw a neurosurgeon in response to her increased pain. The second surgeon to see the patient diagnosed her with a malpositioned pedical screw from her fusion surgery, which was impinging into the spinal cord canal. The neurologist then performed a revision surgery in an attempt to correct the issue, during which he removed the spinal implants. The screws that had been implanted during the original surgery appeared to be loose, and the neurosurgeon noted several additional issues which strongly indicated negligence on the part of the implanting surgeon. The plaintiff is currently unable to work, or to walk without assistance. The plaintiff alleges the defendant surgeon waited too long for revision surgery, resulting in her current condition.

Questions to the Neurosurgery expert and their responses

Do you perform this type of surgery? If so, how often?

I perform this surgery on average 5-10 per week with a good percentage of them being fusions.

What are the common complications following this surgery?

Complications include infection, blood clots, csf leak, hardware failure, adjacent segment disease. Rare complications would be stroke, coma, death, loss of bowel bladder control, paralysis.

What is the standard of care for patients presenting with worsened pain following spinal fusion and lumbar decompression surgery?

In my opinion, the standard of care for a patient with significant new radicular pain is steroids, pain meds and possibly neurontin. If this doesn't quickly help the pain, then a work up needs to be performed. In cases of pedicle screw fusion, I think imaging with CT scan and/or x rays to check screw placement is indicated. Also, MRI can be helpful.

About the expert

This expert is a highly regarded neurosurgeon from the Nashville area. Working at a major medical university, he sees patients on a daily basis and participates in research as well. He earned his MD from the University of Florida College of Medicine, and completed post-graduate training in neurological surgery and neuro-endovascular surgery at Vanderbilt University Medical Center. He is a member of both The American Association of Neurological Surgeons and the Congress of Neurological Surgeons.