Nerve root complications of percutaneous laser-assisted diskectomy performed at outside institutions: a technical...

Two patients, treated with percutaneous laser-assisted diskectomy, developed postoperative nerve root complications. The first patient, whose diskectomy had been performed by a gastroenterologist, suffered an acute foot drop that resolved following delayed surgical diskectomy, whereas the second patient's L4 and L5 root deficits remained permanent. Percutaneous laser-assisted diskectomy, by reducing intradiscal volume, is considered an alternative to open surgery in the management of contained lumbar disc herniations. After an L4-L5 diskectomy and a fenestration procedure performed 2 months later for a sequestrated disc herniation and segmental stenosis, the first patient's foot drop resolved. Unfortunately, the second patient's L4 and L5 root injuries, without MRI and myelo-CT surgical pathology, were complete. The laser-assisted diskectomy may produce reversible and irreversible nerve root injuries.