PG - Non-inquest findings

75y · Male·left retroperitoneal haemorrhage associated with lumbar spine surgery

A 75-year-old man with complex comorbidities including Parkinson's disease and cognitive impairment underwent two-stage lumbar spine surgery for degenerative disc disease with stenosis. Post-operatively, he developed a retroperitoneal haemorrhage which was not identified until 6 days after surgery. An expert neurosurgeon questioned whether the extensive surgical approach was appropriate given his comorbidities and stable spine, suggesting a simpler laminectomy would have sufficed. The coroner found that while earlier CT imaging on post-operative day 4 might have identified the haemorrhage sooner, the standard of care was not breached. Clinical lessons include: considering less extensive surgical options for medically complex elderly patients; earlier imaging when post-operative abdominal symptoms persist despite initial investigation; and careful risk-benefit analysis of anticoagulation in post-operative patients at high bleeding risk.