Emergency Lumbar Disk Operation: How Safe Is it?

It was suggested that emergency operations could represent a risk factor for complications. The purpose of this study was to evaluate whether complication rates are higher in emergency lumbar disk operations compared with elective lumbar disk surgery.  Patient data sets from 575 microscopic lumbar disk surgeries performed within a 5-year period were evaluated in a retrospective study design. There were 498 patients after excluding those who had surgery for recurrent disk herniation. Overall, 460 patients (92.4%) underwent elective surgery (nonemergency group), and 38 patients (7.6%) were operated on in an emergency setting (emergency group). The incidence of dural tears, the frequency of intra- and perioperative complications, the rate of recurrent disk herniation, and the length of hospital stay were evaluated.  No statistically significant differences between the two groups were found with regard to the incidence of dural tears (7.9% in the emergency group, 4.3% in the nonemergency group;  = 0.32), the rate of complications (2.6% in the emergency group, 2.8% in the nonemergency group;  = 0.95), the rate of recurrent disk herniation (8.9% versus 10.5%;  = 0.74), and the length of hospital stay ( = 0.22).  Emergency lumbar disk surgery has a similar safety profile as elective surgery. Patients who present with acute or progressive neurologic deficits and need emergency surgery are not exposed to a higher risk of surgery.