Intraoperative Disc Prolapse During Percutaneous Endoscopic Lumbar Discectomy.

Abstract:

BACKGROUND:Percutaneous endoscopic lumbar discectomy (PELD) is regarded as an alternative treatment for lumbar disc herniation. Although the indication for PELD has expanded with remarkable evolution of the technique, sometimes unexpected complications have occurred during PELD. We report 3 cases of de novo disc prolapse during PELD. CASE DESCRIPTION:In 3 patients who underwent PELD for lumbar disc herniation with local anesthesia, postoperative magnetic resonance imaging demonstrated newly developed up-migrated disc herniation. Compared with their preoperative states, these patients experienced decreased intensity of both leg and back pain. There were no neurologic deficits. PELD was repeated for L1-L2 disc herniation only to relieve compression of the conus medullaris. CONCLUSIONS:Although the incidence was very low (0.3%) and the lesions were nonsymptomatic, de novo disc prolapse may be associated with an inside-out PELD technique. Discography and insertion of the obturator should be handled gently. The possibility of de novo disc prolapse should be kept in mind when performing PELD.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Choi KC,Shim HK,Lee DC,Park CK

doi

10.1016/j.wneu.2018.11.216

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

81-85

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(18)32775-X

journal_volume

123

pub_type

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