Polio survivors face specific surgical complications beyond the standard risks. A significant concern is poor bone healing (non-union), as bones that have borne less weight for decades may be osteoporotic. Another frequent issue is new or increased weakness in muscles adjacent to the surgical site, as these already overworked muscles struggle to adapt to new biomechanics. Furthermore, there are heightened anesthesia risks, including difficult intubation and post-operative respiratory failure, particularly for patients with bulbar polio or pre-existing respiratory weakness. Other notable complications include a higher incidence of post-operative bleeding and hardware failure due to the challenges of securing implants in potentially fragile bone.