Shofwan Said, Liem Liong, Janitra Grady, Basuki Nur, Rhatomy Sholahuddin
Department of Anesthesiology and Intensive Therapy, Sultan Agung Islamic Hospital, Medical Faculty, Sultan Agung Islamic University, Semarang, Central Java, Indonesia.
Consultant Pain Management Amsterdam UMC, Universitair Medische Centra (VUmc), Amsterdam, Netherlands.
Anesth Pain Med. 2020 Dec 28;10(6):e110322. doi: 10.5812/aapm.110322. eCollection 2020 Dec.
Radiofrequency nucleoplasty is a minimally invasive procedure to treat chronic low back pain, especially mild degenerative disc diseases. Discitis after radiofrequency nucleoplasty is a rare case.
A 62-year-old male patient with a chief complaint of 10 years low back pain, gradually worsening for the last two years, a history of hypertension, chronic kidney disease, and routine dialysis twice a week, referred to the center. He underwent a lumbar medial branch block using radiofrequency and radiofrequency nucleoplasty procedure of lumbar 4-5 (L4-L5). Three weeks after the intervention, he could not move his legs, associated with urinary and fecal incontinence. MRI (magnetic resonance imaging) of the lumbar spine was performed, and the results indicated hyperintensity in L4-L5, suspicious of discitis. Laminectomy at L4 and L5 was performed. Eight months after surgery, the patient could feel and lift legs, and urinary and fecal incontinence was also controlled.
Early diagnosis of discitis is critical and challenging. Delay in diagnosis may lead to treatment delay and the development of neurological deficits. Comprehensive treatment with bed rest, antimicrobial therapy, and sensible application of timely surgery are essentials to an optimal outcome.
射频椎间盘成形术是一种治疗慢性下腰痛，尤其是轻度退行性椎间盘疾病的微创手术。射频椎间盘成形术后椎间盘炎是一种罕见病例。
一名62岁男性患者，主诉腰痛10年，近2年逐渐加重，有高血压、慢性肾病病史，每周常规透析2次，转诊至本中心。他接受了腰椎内侧支射频阻滞及腰4-5（L4-L5）射频椎间盘成形术。干预后3周，他无法移动双腿，并伴有大小便失禁。进行了腰椎磁共振成像（MRI）检查，结果显示L4-L5高信号，怀疑为椎间盘炎。实施了L4和L5椎板切除术。术后8个月，患者能够感知并抬起双腿，大小便失禁也得到了控制。
椎间盘炎的早期诊断至关重要且具有挑战性。诊断延迟可能导致治疗延误及神经功能缺损的发生。卧床休息、抗菌治疗以及合理适时地应用手术进行综合治疗是取得最佳疗效的关键。
