[Broken Racz catheter during application (case report)].
The most important complication of lumber disc hernia operations is Failed Back Surgery Syndrome (FBSS), which goes with fibrotic adhesions at the surgical site. The primary treatment applied to the cases that develop FBSS is the placement of Racz catheter under floroscopy and application of epidural neuroplasty which is a three-day procedure. However, this intervention, from which patients benefit a great deal, has some important complications during and after the application. One of these complications is that some pieces of Racz catheter may be broken out and retain at some levels of epidural space and subcutaneous tissue during placement and removal. General approach is to remove the retaining piece surgically. However, there is a less common view that, instead of removing the retaining piece, the patient should be followed up strictly and regularly in terms of neurologic complications. In our case, we decided to perform epidural neuroplasty to the patient diagnosed as FBSS. However, during the placement of the catheter, it was trapped in the left side of L5-S1 foramen by accident due to dense fibrotic tissues, and the subcutaneus part retained in the epidural space. Monthly follow-ups for 12 month were proposed to the patient, while surgery was not recommended. At the end of this period, no sign of infection was observed and neurologic and radiologic findings of the patient did not worsen. It is also interesting that a remarkable recovery was observed in the patient's clinical situation.
Karaman
Haktan
H
Dicle University Faculty of Medicine, Algology Unit, Diyarbakir, Turkey. haktan72@yahoo.com
Oztürkmen Akay
Hatice
H
Turhanoğlu
Selim
S
D002404:Catheterization / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004824:Epidural Space / Q000601:surgery; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects; D011183:Postoperative Complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D011859:Radiography; D012585:Sciatica / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery