A case of nerve root heat injury induced by percutaneous laser disc decompression performed at an outside institution: technical case report.
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.
Kobayashi
Shigeru
S
Department of Orthopaedics and Rehabilitation Medicine, Fukui University School of Medicine, Fukui, Japan. kshigeru@fmsrsa.fukui-med.ac.jp
Uchida
Kenzo
K
Takeno
Kenichi
K
Yayama
Takafumi
T
Nakajima
Hideaki
H
Nomura
Eiki
E
Hayakawa
Katsuhiko
K
Meir
Adam
A
Yonezawa
Takumi
T
Baba
Hisatoshi
H
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