Smuck Matthew, Benny Benoy, Han Alice, Levin Joshua
University of Michigan, Ann Arbor, MI 48108, USA.
Pain Physician. 2007 Sep;10(5):691-6.
Complications reported from percutaneous disc decompression (PDD) include discitis, anaphylaxis (with chemonucleolysis), instability, increased back pain, and reherniation. To the best of our knowledge, there is no report of epidural fibrosis occurring with any of the many types of PDD.
To document a case of epidural fibrosis following PDD with coblation technology (Nucleoplasty), a previously unreported complication of this procedure.
Case report.
Details are presented on a 46-year-old man's history, diagnostic test results, treatments, and progression of his symptoms.
Following PDD with coblation technology at L5-S1, the patient noticed improvement in his left lower extremity radicular symptoms and low back pain. He continued to improve over the following week to near complete relief. He resumed his normal activities. Three months post treatment, he experienced a recurrence of his radicular pain with a diminished left Achilles reflex. A subsequent MRI showed improvement of the previous left paracentral protrusion at L5-S1 along with a new contrast enhancing soft tissue mass. This mass, consistent with epidural fibrosis, was located in the left antero-lateral spinal canal and encased the left S1 nerve root. On the patient's next follow-up visit, he reported spontaneous resolution in his symptoms. He had stopped all pain medications and returned to his usual activities.
This case is the first reported occurrence of epidural fibrosis following percutaneous lumbar disc decompression.
经皮椎间盘减压术（PDD）报告的并发症包括椎间盘炎、过敏反应（化学髓核溶解术相关）、不稳定、背痛加重和再突出。据我们所知，在众多类型的PDD中，尚无硬膜外纤维化发生的报告。
记录1例使用等离子消融技术（髓核成形术）进行PDD后发生硬膜外纤维化的病例，这是该手术此前未报告过的并发症。
病例报告。
详细介绍了一名46岁男性的病史、诊断检查结果、治疗情况及症状进展。
在L5-S1节段采用等离子消融技术进行PDD后，患者左下肢神经根性症状和腰痛有所改善。在接下来的一周里他持续好转，几乎完全缓解。他恢复了正常活动。治疗后三个月，他出现神经根性疼痛复发，左侧跟腱反射减弱。随后的MRI显示，之前L5-S1节段左侧旁中央突出有所改善，同时出现一个新的强化软组织肿块。这个与硬膜外纤维化相符的肿块位于左前外侧椎管内，包绕左侧S1神经根。在患者的下一次随访中，他报告症状自行缓解。他已停用所有止痛药物并恢复了日常活动。
该病例是经皮腰椎间盘减压术后首次报告发生硬膜外纤维化的病例。
