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Interventionist performs a "sham" lumbar microdiscectomy: Should interventionalists be performing spinal surgery?
Ramsis F Ghaly1,2,3, Zinaida Perciuleac1, Kenneth D Candido1,3
1Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois, United States.
Surgical Neurology International
|January 27, 2021
Summary
Interventional pain management specialists, not trained in spinal surgery, should not perform procedures like lumbar microdiscectomy. A case revealed a sham surgery led to severe complications, highlighting the need for specialized surgical training.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Pain Management
Background:
- Spinal surgery requires specialized training by neurosurgeons or orthopedists.
- Interventional pain management specialists (IPMS) may perform procedures on the spine.
- Patient safety is paramount in all surgical interventions.
Observation:
- A patient experienced worsening sciatica after epidural steroid injections by an IPMS.
- The IPMS claimed to be a surgeon and performed a microdiscectomy.
- The patient later developed cauda equina syndrome, requiring surgery by a neurosurgeon.
Findings:
- The initial microdiscectomy performed by the IPMS was found to be a "sham" procedure with no surgical evidence.
- The patient's cauda equina syndrome resolved after the neurosurgeon's intervention.
- Lack of specialized training can lead to detrimental patient outcomes.
Implications:
- IPMS without neurosurgical training should not perform spinal surgeries.
- The case underscores the critical importance of surgical expertise in spinal procedures.
- Patient outcomes are significantly better when procedures are performed by appropriately trained specialists.
