Sacral root injury during trans-sacral epiduroscopic laser decompression: A case report.

Area of Science:

• Neurosurgery
• Pain Management
• Urology

Background:

• Trans-sacral epiduroscopic laser decompression (SELD) is a treatment for lower back pain (LBP) and radicular pain from herniated lumbar discs (HLD).
• While effective short-term, potential complications of SELD are not well-documented.

Observation:

• A 36-year-old male patient experienced voiding and defecation difficulties, along with sensory deficits in the S3-S5 dermatome after SELD for L5-S1 HLD.
• Urodynamic studies revealed an areflexic neurogenic bladder, and electromyography showed delayed bulbocavernosus reflex (BCR) latency, indicating sacral nerve root injury.

Findings:

• The patient's symptoms of neurogenic bladder and bowel dysfunction, along with sensory deficits, were attributed to sacral nerve root injury post-SELD.
• The patient showed significant recovery in voiding and defecation functions within three months.

Implications:

• This case highlights a rare complication of SELD involving sacral nerve root injury.
• Clinicians performing SELD must be aware of the risk of sacral nerve root injury and its potential neurological consequences.