Non-Standard Surgical Technique Causes Chronic Pain for Spinal Fixation Patient

This case involves a middle-aged male patient in New Hampshire who underwent a spinal fixation procedure using only bone cement. Since undergoing the procedure, the patient had suffered from ongoing pain and muscle tension, alleging she was suffering from fibromyalgia. The patient sought a second opinion from another neurosurgeon who attributed the patient’s ongoing neck problems to the operating physician’s surgical technique, which was described as “non-standard.” The plaintiff alleged that the use of methylmethacrylate (bone cement) without a graft/spacer was not an acceptable technique for interbody fusion when the surgery was originally performed.

Question(s) For Expert Witness

  • 1. Do you routinely treat patients and perform the procedure similar to the one described in the case?
  • 2. What are some of the common complications of the procedure? Have you ever had a patient develop the outcome described in the case? If so, please explain.
  • 3. Please share your preliminary opinion based on the case summary. Was the use of methylmethacrylate without a graft/spacer an acceptable technique for interbody fusion?

Expert Witness Response E-001529

I perform 5-10 spine operations per week, including many anterior cervical discectomy and fusion procedures. I do routinely perform anterior cervical discectomy and fusion, however I do not use bone cement. There are several complications to keep in mind for this procedure including infection, bleeding, stroke, coma, death, csf leak, nerve injury, paralysis, vocal cord injury, trouble swallowing, hardware failure, adjacent segment disease, need for further surgery, and failure to improve. Chronic pain and “muscle tension” is possible with any spine procedure. I would need to review all of the notes but I would say the use of methylmethacrylate is not a standard approach.

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