Recurrent Lumbar Disc Herniation Recurrence After Percutaneous Endoscopic Lumbar Discectomy: A Case Report

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2018 Aug 26

PMID 30142797

Citations 3

Authors

Yuanyi Wang

Cong Ning

Feng Xu

Yipeng Xiang

Liyu Yao

Yadong Liu

Wenjing Zhang

Xiuying Huang

Changfeng Fu

Affiliations

Soon will be listed here.

Abstract

Rationale: Lumbar disc herniation (LDH) is a degenerative disease and affects human health. Although percutaneous endoscopic lumbar discectomy (PELD) can redeem the living quality of patient with LDH rapidly, it appears weak to limit the recurrence rate of LDH.

Patient Concerns: A 52-year-old male suffered lower back pain and lower limb paralysis for 20 years. However, conservative treatment could not relieve above-mentioned symptoms after doing heavy labor.

Diagnoses: Computed tomography (CT) revealed a disc fragment had migrated to the inferior edge of the L5 pedicle. Magnetic resonance imaging (MRI) demonstrated a type 2 Modic change (MC) at L5 and spinal canal stenosis at L4-L5. Based on these findings, the patient was diagnosed with L4-L5 disc herniation and secondary lumbar stenosis.

Interventions: The patient underwent surgery twice for PELD at L4-L5 in 1 month. Symptoms were not improved effectively until the conventional posterior discectomy with fusion was performed.

Outcomes: No signs of recurrence have been detected in 6 months of follow-up, except for mild lower back pain meeting the temperature change.

Lessons: Rapid decompression and instant therapeutic effect do not mean extending the indications of PELD. It is unreasonable to revise the recurrent LDH or treat the primary LDH with PELD under inadequate preoperative assessment.

Citing Articles

Surgical Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion for Highly Migrated Lumbar Disc Herniation.

Wang A, Yu Z J Pain Res. 2021; 14:1587-1592.

PMID: 34113166 PMC: 8187084. DOI: 10.2147/JPR.S303930.

Comparison of Percutaneous Endoscopic Lumbar Discectomy with Minimally Invasive Transforaminal Lumbar Interbody Fusion as a Revision Surgery for Recurrent Lumbar Disc Herniation after Percutaneous Endoscopic Lumbar Discectomy.

Wang A, Yu Z Ther Clin Risk Manag. 2020; 16:1185-1193.

PMID: 33363376 PMC: 7754645. DOI: 10.2147/TCRM.S283652.

Percutaneous Endoscopic Lumbar Discectomy on L5-S1: Comparison of Modified Knee-Chest and Prone Position in Terms of Foraminal Height and Puncture Time.

Ren D, Lin Y, Du P, Zhang Z, Wang X, Li F Chin Med J (Engl). 2018; 131(21):2605-2607.

PMID: 30381595 PMC: 6213843. DOI: 10.4103/0366-6999.244122.

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