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经椎间孔后路腰椎间盘切除术术后癫痫发作

Postoperative seizure following transforaminal percutaneous endoscopic lumbar discectomy.

作者信息

Kertmen Hayri, Gürer Bora, Yilmaz Erdal Resit, Sekerci Zeki

机构信息

Department of Neurosurgery Clinic, Ministry of Health Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.

出版信息

Asian J Neurosurg. 2016 Oct-Dec;11(4):450. doi: 10.4103/1793-5482.145119.

Abstract

Endoscopic surgery for lumbar disc herniation has been available for more than 30 years. Transforaminal percutaneous endoscopic lumbar discectomy is a well-known, safe, and effective method used for the treatment of the lumbar disc herniation. The published complications of the transforaminal percutaneous endoscopic lumbar discectomy consist of infections, thrombophlebitis, dysesthesia, dural tear, vascular injury, and death. Seizure after transforaminal percutaneous endoscopic lumbar discectomy is an extremely rare complication. A 20-year-old patient applied at our department who had undergone transforaminal percutaneous endoscopic lumbar. During the procedure, while performing the discography, non-ionic contrast media was administered into the thecal sac inadvertently. Two hours after surgery, the patient developed generalized tonic-clonic seizure of 5-min duration. Diagnosis of iohexol-induced seizure was made and the patient was treated supportively without anti-epileptics. Here we present the first case of seizure after transforaminal percutaneous endoscopic lumbar discectomy, which was caused by inadvertent administration of the contrast media into the thecal sac.

摘要

腰椎间盘突出症的内镜手术已经开展30多年了。经椎间孔经皮内镜下腰椎间盘切除术是一种治疗腰椎间盘突出症的知名、安全且有效的方法。已公布的经椎间孔经皮内镜下腰椎间盘切除术的并发症包括感染、血栓性静脉炎、感觉异常、硬脊膜撕裂、血管损伤和死亡。经椎间孔经皮内镜下腰椎间盘切除术后癫痫发作是一种极其罕见的并发症。一名20岁的患者到我们科室就诊,该患者接受了经椎间孔经皮内镜下腰椎手术。在手术过程中,进行椎间盘造影时,非离子型造影剂意外注入了硬膜囊。术后两小时,患者出现了持续5分钟的全身性强直阵挛性癫痫发作。诊断为碘海醇诱发的癫痫发作,患者接受了支持治疗,未使用抗癫痫药物。在此我们报告首例经椎间孔经皮内镜下腰椎间盘切除术后癫痫发作病例,该发作由造影剂意外注入硬膜囊引起。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c246/4974983/850b3d35970c/AJNS-11-450a-g001.jpg

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