What is the most common cause of neurological deficit as a complication of spinal surgery?

Spinal cord ischemia is recognized as the most common cause of neurological deficit arising as a complication during or after spinal surgery. This condition can occur due to various factors, including inadequate blood flow to the spinal cord during surgical manipulation, trauma, or prolonged retraction. When the blood supply is compromised, it can quickly lead to neurological deficits, such as weakness, sensory loss, or even paralysis, depending on the severity and duration of the ischemia.

In spinal surgery, maintaining adequate perfusion to neural structures is critical as the surgical field can involve manipulation of arteries supplying the spinal cord, making it essential for surgeons to be vigilant about potential ischemic events. Understanding that spinal cord ischemia often leads to acute, noticeable deficits can help in recognizing its significance as a complication in surgical practice.

In contrast, while nerve root compression, postoperative infections, and hemorrhage can also result in deficits, they are often less common than ischemia in the context of surgical complications. Nerve root compression typically leads to radicular pain rather than widespread deficits, infections often have a more delayed presentation and may not directly cause immediate neurological deficits, and hemorrhage, while serious, is not as frequently encountered compared to ischemic events.