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Contralateral lumbosacral plexopathy following lumbar microdiscectomy.

Isabel Tulloch¹, Riaz Ali¹, Marios C Papadopoulos¹

¹Neurosurgery, St George's Hospital, London, UK.

British Journal of Neurosurgery

|January 28, 2018

Summary

A rare complication, contralateral lumbosacral plexopathy, occurred in a patient two days after lumbar microdiscectomy. This case suggests a potential immune-mediated inflammatory mechanism, similar to post-operative brachial neuritis.

Keywords:

Lumbosacral plexopathy auto-immune brachial neuritis microdiscectomy plexus sarcoidosis

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Area of Science:

Neurology
Neurosurgery
Immunology

Background:

Lumbar microdiscectomy is a common surgical procedure for spinal disc herniation.
Lumbosacral plexopathy is a rare but serious neurological complication.
Post-operative brachial neuritis is a known complication following cervical spine surgery.

Observation:

A 51-year-old female developed contralateral lumbosacral plexopathy two days post-lumbar microdiscectomy.
This represents the first reported instance of this complication after this specific surgical procedure.

Findings:

The case highlights a potential link between spinal surgery and delayed-onset plexopathy.
Pathophysiological mechanisms may involve an immune-mediated inflammatory process.
The contralateral presentation is a unique and notable aspect of this case.

Implications:

This finding necessitates further investigation into the immunopathogenesis of post-operative neurological deficits.
Clinical awareness should be raised regarding this rare complication following lumbar spine surgery.
The proposed immune-mediated mechanism warrants comparative studies with brachial plexopathy.