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A giant herniated disc following intradiscal electrothermal therapy
Steven P Cohen1, Thomas Larkin, David W Polly
1Pain Management Center, Department of Anesthesiology, Walter Reed Army Medical Center, Washington, DC, USA. Steven.Cohen@med.nyu.edu
Journal of Spinal Disorders & Techniques
|December 7, 2002
Summary
Intradiscal electrothermal therapy for back pain may cause complications like disc herniation. A lumbar fusion successfully treated a soldier
Area of Science:
- Orthopedics
- Neurosurgery
- Pain Management
Background:
- Intradiscal electrothermal therapy (IDET) is a minimally invasive procedure for discogenic back pain.
- Noncontrolled studies suggest good outcomes and low complication rates for IDET.
- Discogenic pain affects many individuals, necessitating effective treatment options.
Observation:
- A 29-year-old soldier with L4-L5 and L5-S1 discogenic pain underwent two-level IDET.
- Pre-procedure MRI showed a small L5-S1 herniation without radiculitis.
- Post-procedure, the patient developed radicular symptoms and a large L5-S1 herniation compressing the S1 nerve root.
Findings:
- The patient experienced significant radicular symptoms after IDET.
- Follow-up imaging confirmed a large L5-S1 disc herniation.
- Subsequent lumbar fusion at L5-S1 provided substantial pain relief.
Implications:
- This case highlights potential complications of IDET, including disc herniation and nerve root compression.
- Lumbar fusion can be an effective treatment for refractory discogenic pain and associated radiculopathy.
- Careful patient selection and monitoring are crucial for procedures like IDET.