Epstein N E
Department of Surgery, North Shore University Hospital, Manhasset, New York.
J Spinal Disord. 1994 Dec;7(6):510-2.
Two patients, treated with percutaneous laser-assisted diskectomy, developed postoperative nerve root complications. The first patient, whose diskectomy had been performed by a gastroenterologist, suffered an acute foot drop that resolved following delayed surgical diskectomy, whereas the second patient's L4 and L5 root deficits remained permanent. Percutaneous laser-assisted diskectomy, by reducing intradiscal volume, is considered an alternative to open surgery in the management of contained lumbar disc herniations. After an L4-L5 diskectomy and a fenestration procedure performed 2 months later for a sequestrated disc herniation and segmental stenosis, the first patient's foot drop resolved. Unfortunately, the second patient's L4 and L5 root injuries, without MRI and myelo-CT surgical pathology, were complete. The laser-assisted diskectomy may produce reversible and irreversible nerve root injuries.
两名接受经皮激光辅助椎间盘切除术的患者出现了术后神经根并发症。第一名患者由胃肠病学家进行椎间盘切除术，术后出现急性足下垂，经延迟手术椎间盘切除术后症状缓解；而第二名患者的L4和L5神经根缺损则持续存在。经皮激光辅助椎间盘切除术通过减少椎间盘内体积，被认为是治疗包容性腰椎间盘突出症的一种开放性手术替代方法。第一名患者在接受L4-L5椎间盘切除术以及两个月后因游离型椎间盘突出症和节段性狭窄进行开窗手术后，足下垂症状得到缓解。不幸的是，第二名患者的L4和L5神经根损伤在没有MRI和脊髓CT手术病理检查的情况下已完全形成。激光辅助椎间盘切除术可能会导致可逆和不可逆的神经根损伤。
