Epidural Hematoma After Trans-Sacral Epiduroscopic Laser Decompression: A Case Report

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery
• Spinal Procedures

Background:

• Trans-sacral epiduroscopic laser decompression (SELD) is a minimally invasive technique for treating herniated lumbar discs.
• The procedure involves laser ablation of the herniated disc material.
• The rich epidural venous plexus presents a potential risk for epidural hematoma formation.

Observation:

• A 57-year-old woman experienced complete motor weakness in her right leg one day post-SELD.
• The patient had undergone SELD for L5-S1 disc protrusion causing lower back and right buttock pain.
• Lumbar MRI revealed a significant epidural hematoma compressing the thecal sac from L1 to L5.

Findings:

• Surgical decompression via laminectomy and hematoma evacuation was performed.
• The patient demonstrated near-complete motor recovery in the right leg two months after surgery.
• This case illustrates a rare but serious complication of SELD.

Implications:

• Clinicians must be aware of the potential for lumbar epidural hematoma following SELD.
• Careful patient selection and monitoring are crucial for this spinal procedure.
• Prompt diagnosis and surgical intervention are key to favorable outcomes in post-SELD hematoma cases.