Nerve root complications of percutaneous laser-assisted diskectomy performed at outside institutions: a technical note.
Two patients, treated with percutaneous laser-assisted diskectomy, developed postoperative nerve root complications. The first patient, whose diskectomy had been performed by a gastroenterologist, suffered an acute foot drop that resolved following delayed surgical diskectomy, whereas the second patient's L4 and L5 root deficits remained permanent. Percutaneous laser-assisted diskectomy, by reducing intradiscal volume, is considered an alternative to open surgery in the management of contained lumbar disc herniations. After an L4-L5 diskectomy and a fenestration procedure performed 2 months later for a sequestrated disc herniation and segmental stenosis, the first patient's foot drop resolved. Unfortunately, the second patient's L4 and L5 root injuries, without MRI and myelo-CT surgical pathology, were complete. The laser-assisted diskectomy may produce reversible and irreversible nerve root injuries.
Epstein
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Department of Surgery, North Shore University Hospital, Manhasset, New York.
D000328:Adult; D000368:Aged; D017587:Diskectomy, Percutaneous / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D053685:Laser Therapy / Q000009:adverse effects*; D008297:Male; D013126:Spinal Nerve Roots / Q000293:injuries*