Surgically confirmed cauda equina and nerve root injury following percutaneous discectomy at an outside institution: a case report

A 39-year-old woman sustained a permanent nerve root and cauda equina injury following a left-sided L5-S1 automated percutaneous discectomy (PERC) performed with the Nucleotome at an outside institution. Despite delayed surgery, which included excision of a sequestrated L5-S1 disc on the right and intradural exploration and resultant confirmation of a disrupted cauda equina, S1 radiculopathy, sacral numbness, and overflow incontinence persisted. Although PERC using the Nucleotome has been accepted by some as a safe alternative to the surgical management of disc disease, the paucity of similar complications reported in the literature may more closely reflect the medicolegal climate rather than the inherent safety of this technique.