Awareness of Risk Factors for Iatrogenic Nerve Rupture in Posterior Surgery for Lumbar Degenerative Disease

Abstract

Introduction: There are few reports on iatrogenic nerve rupture in lumbar degenerative disease, which is an irreparable complication; thus, we examined cases of iatrogenic nerve rupture in department to obtain methods for its prevention.

Methods: Cases of iatrogenic nerve rupture were extracted from the incident reports of 3,180 patients who underwent posterior surgery for lumbar degenerative disease, and the risk factors and causes were investigated.

Results: There were 10 cases (0.31%) of iatrogenic nerve rupture. The risk factors were disc herniation as a disease, decompression, herniotomy, and laminectomy with Kerrison rongeurs in the presence of herniation as a surgical procedure. The cause was misidentification of the S2 nerve root as S1 in L5/S Love surgery (two cases), penetration of the medially moving drill tip into the epidural space, misidentification of nerve root compressed by a hernia, and dislodgement of Love retractor in L2/L3 hernia.

Conclusions: Awareness of these risk factors can help reduce cases of iatrogenic nerve rupture.