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Complications of Endoscopic Lumbar Discectomy

Complications of Endoscopic Lumbar Discectomy. 안광준 , 최우진 , 김관태 허리사랑병원 . Data of hurisarang hospital . Period :2005. 2 ~ 2006.8 ( 1 년 6 개월 ) • Cases : 418 endoscopic discectomy. Cases ( N=418 ). ILD: interlaminar approach, PLD: posterolateral approach. Complications .

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Complications of Endoscopic Lumbar Discectomy

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  1. Complications of Endoscopic Lumbar Discectomy 안광준, 최우진, 김관태 허리사랑병원

  2. Data of hurisarang hospital • Period :2005. 2 ~ 2006.8 ( 1년 6개월 ) • Cases : 418 endoscopic discectomy

  3. Cases ( N=418 ) ILD: interlaminar approach, PLD: posterolateral approach

  4. Complications • Vascular injury • Neural injury • Dura tear ( CSF leakage ) • Infection • Recurrence • Etc

  5. 1. Anterior Vessel injury • Incidence 0.045% / open surgery 0% / survey period

  6. Avoidance Confirm always needle placement 9 inches C-arm : lateral view is more safe than AP

  7. 31/F, huge HNP L4-5 Rt postop preop

  8. Very thin case : careful !

  9. 2. Nerve injury • Incidence 0.2% / open surgery 0.2% / survey period

  10. Avoidance Adhesion Compression Shallow Anesthesia

  11. Case

  12. 3. Dura tear • Incidence 7.2% - 0.8% / open surgery 0.9% / survey period

  13. Avoidance Adhesion Don’t Worry

  14. Case 29/ M recurred HNP L5-S1 Lt.

  15. 4. infection • Incidence 0.13% - 0.9% / open surgery 0.4% /survey period

  16. Infection type Aseptic discitis > septic discitis

  17. • Avoidance + remove debris

  18. Case 56/M , HNP L3-4 Rt. Upward ,PreOP.

  19. Post Op. MRI

  20. POD # 12

  21. 5. Recurrent disc prolapse • Incidence 5-7% / open surgery 3.1% / survey period

  22. Avoidance < Recommend Remove sufficient disc Use gelfoam ?

  23. Conclusion • Vascular injury : lateral view • Neural injury : shallow anesthesia • Dura tear ( CSF leakage): don’t worry • Infection : debris • Recurrence : Remove sufficient disc

  24. 대단히 감사합니다.

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