title: A case of nerve root heat injury induced by percutaneous laser disc decompression performed at an outside institution: technical case report.
abstract: OBJECTIVE
  In recent years, percutaneous laser disc decompression (PLDD) has become a routine surgical procedure because it can be performed under local anesthesia and is minimally invasive. However, there is a risk of nerve root and endplate injury owing to heat generated by laser irradiation during PLDD. We recently performed salvage surgery on a patient with heat injury to the L5 nerve root that developed after PLDD.
  
  
  METHODS
  One month before presenting to our hospital, the patient underwent two sessions of PLDD for lumbar vertebral disk herniation at another institution. The patient developed worsening sciatica, as well as bowel and urinary problems after the PLDD.
  
  
  METHODS
  We performed salvage surgery after PLDD. The intraoperative findings in the present case included carbon spots in the dura mater of the nerve root and a disc herniation strongly adherent to the nerve roots. These findings indicate that the area adjacent to the nerve roots was damaged by excessive heat during laser irradiation.
  
  
  CONCLUSIONS
  When salvage surgery is performed after a PLDD procedure, disc and nerve root injuries owing to laser heat energy must be considered.
authors.affiliation: Department of Orthopaedics and Rehabilitation Medicine, Fukui University School of Medicine, Fukui, Japan. kshigeru@fmsrsa.fukui-med.ac.jp
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Kenzo
authors.initials: K
authors.lastname: Uchida
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takeno
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yayama
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nakajima
authors.forename: Eiki
authors.initials: E
authors.lastname: Nomura
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Hayakawa
authors.forename: Adam
authors.initials: A
authors.lastname: Meir
authors.forename: Takumi
authors.initials: T
authors.lastname: Yonezawa
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Baba
mesh_terms: D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods; D004388:Dura Mater / Q000473:pathology; D053159:Dysuria / Q000209:etiology / Q000601:surgery; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000601:surgery*; D053685:Laser Therapy / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D012585:Sciatica / Q000209:etiology* / Q000601:surgery; D013126:Spinal Nerve Roots / Q000473:pathology*; D000267:Tissue Adhesions / Q000209:etiology