Risks and Complications

Decompression Surgery

Every Surgery Carries Some Risk

Your surgical team will take every precaution to keep you safe, but no surgery is completely free of risk.

Main Risks

Risk	Frequency	Explanation
Infection (SSI)	1–3%	Wound or deep infection; may require additional surgery
Dural tear	About 9%	The membrane surrounding the spinal cord may be damaged, causing spinal fluid leakage
Nerve injury	Less than 1%	Worsening numbness or weakness in the legs
Bleeding or hematoma	Rare	A blood clot may form and compress nerves again
Bladder or bowel problems	Rare	Temporary or lasting dysfunction due to nerve damage
Deep vein thrombosis	Rare	Blood clots forming in the leg veins
Reoperation	8–23%	8% at 2 years, 23% at 10 years

Long-term consideration:

If a significant amount of bone is removed, the spine may become unstable over time, causing pain. In such cases, a secondary fusion surgery may be needed.

Guideline data on complications:

Studies cited in the guidelines report an overall complication rate of 10–24%, though definitions and follow-up periods vary widely. A systematic review of 9 randomized controlled trials including 1,658 patients found no significant difference in complication rates between surgical and conservative treatment groups.

How to Reduce Your Risk

Quit smoking — Smoking increases infection risk
Manage blood sugar — Especially important if you have diabetes
Optimize nutrition — Good health before surgery aids recovery
Rehabilitate early — Getting up and moving soon after surgery helps

If you have other medical conditions (heart disease, diabetes, dialysis, etc.), discuss your individual risks with your doctor.

A Note for Patients with Obesity

From the guideline commentary:

For patients with a BMI of 30 or higher, decompression surgery can still be effective, but the rate of symptom improvement tends to be lower compared to non-obese patients. Back pain is also more likely to persist significantly after decompression alone.