Sciatica Research Today is a free monthly online journal that collates and summarizes the latest research about Sciatica, including details on treatment, prevention, medication.

A CASE OF NERVE ROOT HEAT INJURY INDUCED BY PERCUTANEOUS LASER DISC DECOMPRESSION PERFORMED AT AN OUTSIDE INSTITUTION: TECHNICAL CASE REPORT.

Kobayashi S, Uchida K, Takeno K, Yayama T, Nakajima H, Nomura E, Hayakawa K, Meir A, Yonezawa T, Baba H

Department of Orthopaedics and Rehabilitation Medicine, Fukui University School of Medicine, Fukui, Japan (Kobayashi) (Takeno) (Baba) Department of Orthopaedic Surgery, Fukui University School of Medicine, Fukui, Japan (Uchida) (Yayama) (Nakajima) (Nomura) (Meir) (Yonezawa) Department of Radiology and Orthopaedics, Aikou Orthopaedic Hospital, Aichi, Japan (Hayakawa).

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. CLINICAL PRESENTATION: 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. INTERVENTION: 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. CONCLUSION: When salvage surgery is performed after a PLDD procedure, disc and nerve root injuries owing to laser heat energy must be considered.

Published 13 February 2007 in Neurosurgery, 60(2): E171-E172.
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