Yeonkyu Yu1, Tae Hoon Kim2, Sang Ho Lee3, Min Cheol Chang4. 1. Department of Anesthesiology, Wooridul Spine Hospital, Seoul, Republic of Korea. 2. Department of Physical Medicine and Rehabilitation, Wooridul Spine Hospital, Seoul, Republic of Korea. 3. Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Republic of Korea. 4. Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Abstract
Objective: In this study, we report a patient who developed lumbar epidural hematoma after trans-sacral epiduroscopic laser decompression (SELD). Background: SELD is a nonoperative minimally invasive spinal procedure, in which a herniated lumbar disk can be ablated by laser. Because of the rich epidural venous plexus, the procedure might have a risk of epidural hematoma. Materials and methods: A 57-year-old woman underwent the SELD procedure for the treatment of lower back and right buttock pain due to disk protrusion at L5-S1. One day after the procedure, complete motor weakness was observed in the right leg. Results: Lumbar magnetic resonance imaging revealed epidural hematoma at the L1-L5 levels, compressing the thecal sac. Using a posterior approach, decompressive subtotal laminectomy on L1 and total laminectomy on L2-L5 with evacuation of the hematoma were performed. Two months postoperatively, near complete resolution of the motor weakness in the right leg was observed. Conclusions: Clinicians should keep in mind the likelihood of epidural hematoma after SELD.
Objective: In this study, we report a patient who developed lumbar epidural hematoma after trans-sacral epiduroscopic laser decompression (SELD). Background: SELD is a nonoperative minimally invasive spinal procedure, in which a herniated lumbar disk can be ablated by laser. Because of the rich epidural venous plexus, the procedure might have a risk of epidural hematoma. Materials and methods: A 57-year-old woman underwent the SELD procedure for the treatment of lower back and right buttock pain due to disk protrusion at L5-S1. One day after the procedure, complete motor weakness was observed in the right leg. Results: Lumbar magnetic resonance imaging revealed epidural hematoma at the L1-L5 levels, compressing the thecal sac. Using a posterior approach, decompressive subtotal laminectomy on L1 and total laminectomy on L2-L5 with evacuation of the hematoma were performed. Two months postoperatively, near complete resolution of the motor weakness in the right leg was observed. Conclusions: Clinicians should keep in mind the likelihood of epidural hematoma after SELD.
Authors: Matthijs W Geudeke; Annelot C Krediet; Süleyman Bilecen; Frank J P M Huygen; Mienke Rijsdijk Journal: Pain Pract Date: 2020-12-26 Impact factor: 3.183