Postoperative radicular neuroma

2001 ◽  
Vol 11 (5) ◽  
pp. 1-3 ◽  
Author(s):  
Tahsin Erman ◽  
Metin Tuna ◽  
A. İskender Göçer ◽  
Faruk İdan ◽  
Erol Akgül ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Lumbar Disc ◽  
Failed Back Surgery Syndrome ◽  
Lumbar Discectomy ◽  
Intervertebral Disc Herniation ◽  
Intractable Pain ◽  
Nerve Root Injury ◽  
Root Injury ◽  
Failed Back Surgery ◽  
Back Surgery

Lumbar discectomy is the most common surgical procedure performed in neurosurgery clinics. Such a large number of procedures underscore not only the prevalence of conditions such as intervertebral disc herniation, but also the strong belief of surgeons that the operation does provide benefits to patients suffering from sciatica. In spite of this belief, sciatic pain may continue after the surgery. The recurrence of sciatic and/or back pain after primary discectomy is called the “failed back surgery syndrome.” The rate of the complications involved in standard lumbar discectomy ranges from 5.4 to 14%. One of the complications of the lumbar disc surgery is nerve root injury. The complication rate of this injury ranges from 0.7 to 2.2%. Postoperative radicular neuroma must be considered in differential diagnosis for the patient who has failed back surgery syndrome. In this study the authors evaluate a patient who had undergone surgery for lumbar disc herniation and suffered intractable pain. A traumatic radicular neuroma is demonstrated and the pertinent literature is presented.

scholarly journals Complications of Lumbar Disc Herniation Following Full-endoscopic Interlaminar Lumbar Discectomy: A Large, Single-Center, Retrospective Study

2017 ◽  
Vol 3 (20;3) ◽  
pp. E379-E387
Author(s):  
Jian-Cheng Zeng
Keyword(s):  
Retrospective Study ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Complication Rate ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Single Center ◽  
Nerve Root Injury ◽  
Root Injury ◽  
Recurrent Herniation

Background: The new surgical procedure of full-endoscopic interlaminar lumbar discectomy (FILD) has achieved favorable effects in the treatment of lumbar disc herniation (LDH). Along with the wide range of applications of FILD, a series of complications related to the operation has gradually emerged. Objective: To describe the types, incidences, and characteristics of complications following FILD and to explore preventative and treatment measures. Study Design: Retrospective, observational study. Setting: A spine center affiliated with a large general hospital. Method: In total, 479 patients with LDH underwent FILDs that were performed by a single experienced spine surgeon between January 2010 and April 2013.Data concerning the complications were recorded. Results: All 479 cases successfully underwent the procedure. A total of 482 procedures were completed. The mean follow-up time was 44.3 months with a range of 24 to 60 months. The average patient age was 47.8 years with a range of 16 to 76 years. Twenty-nine (6.0%) related complications emerged, including 3 cases (0.6%) of incomplete decompression in which the symptoms gradually decreased following 3 – 6 weeks of conservative treatment, 2 cases (0.4%) of nerve root injury in which the patients recovered well following 1 – 3 months of neurotrophic drug and functional exercise treatment, 15 cases (3.1%) of paresthesia that gradually improved following 1 – 8 weeks of rehabilitation exercises and treatment with mecobalamin and pregabalin, and 9 cases of recurrent herniation (1.9%). The latter condition was controlled in 4 cases with a conservative method, and 5 of these cases underwent reoperations that included 3 traditional open surgeries and 2 FILDs. Furthermore, the complication rate for the first 100 cases was 18%. This rate decreased to 2.9% for cases 101 – 479. The incidence of L4-5 herniation (8.2%) was significantly greater than that of L5-S1 (4.5%). Limitations: This is a retrospective study, and some bias exists due to the single-center study design. Conclusion: FILD is a surgical approach that has a low complication rate. Incomplete decompression, nerve root injury, paresthesia, and recurrent herniation were observed in our study. Some effective measures can prevent and reduce the incidence of the complications including strict indications for surgery, a thorough action plan, and a high level of surgical skill. Key words: Complication, lumbar disc herniation, lumbar discectomy, endoscopic, inter-laminar discectomy, minimally invasive spine surgery

Long-term Outcome of 104 Patients after Lumbar Sequestrectomy According to Williams

Neurosurgery ◽  
2001 ◽  
Vol 49 (2) ◽  
pp. 329-335 ◽  
Author(s):  
Markus Wenger ◽  
Luigi Mariani ◽  
Andreas Kalbarczyk ◽  
Uli Gröger
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Failed Back Surgery Syndrome ◽  
Neurological Dysfunction ◽  
Long Term Outcome ◽  
Failed Back Surgery ◽  
Back Surgery ◽  
Clinical Records

Abstract OBJECTIVE The authors report the late outcome of 104 consecutive patients after Williams' sequestrectomy for virgin lumbar disc herniation. METHODS The clinical records and the mailed questionnaires of 38 women and 66 men operated consecutively between March 1991 and November 1993 were analyzed retrospectively. In these 104 patients, 105 Williams' sequestrectomies were performed. RESULTS The mean age at operation was 50.5 years (range, 23.2–86.7 yr), and follow-up ranged from 4.1 to 6.9 years (mean, 5.3 yr). Success rates, including excellent, good, and fair results, were 92.5%, 94.7%, and 93.3% for lumbalgia, radicular pain, and neurological dysfunction, respectively. Only a few patients did not improve or presented with worsened symptoms. Three of four patients with cauda equina syndrome recovered immediately after the intervention. There were eight (7.7%) minor postoperative complications, which were treated conservatively. Three women and three men (5.8%) underwent a revision procedure for a recurrent lumbar disc herniation at the same level after 0.4 to 3.1 years (mean, 1.8 yr). Two (1.9%) of these patients underwent further operations because of reherniation, and they required internal instrumentation eventually because of failed back surgery syndrome. CONCLUSION Williams' conservative approach with sequestrectomy alone is a safe operative modality. It should be used whenever possible. As demonstrated in our series with a long follow-up time, the results are as favorable as or better than results after standard microsurgical lumbar discectomy with curettement of the interspace. Whether the incidence of failed back surgery syndrome can be reduced by this approach remains to be proved.

Computed Tomography of the Postoperative Intervertebral Disc and Lumbar Spinal Canal: Serial Long-Term Investigation in 19 Patients after Successful Operation for Lumbar Disc Herniation

Neurosurgery ◽  
1991 ◽  
Vol 29 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Raoul Heilbronner ◽  
Heinz Fankhauser ◽  
Pierre Schnyder ◽  
Nicolas de Tribolet
Keyword(s):  
Contrast Enhancement ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Signs And Symptoms ◽  
Failed Back Surgery Syndrome ◽  
Ct Scans ◽  
X Rays ◽  
Successful Operation ◽  
Failed Back Surgery

Abstract The first part of this work, published in 1988, included 25 patients who had computed tomographic (CT) scans without contrast enhancement and plain x-rays of the lumbar spine before, 1 week after, and 6 to 7 weeks after a successful operation for lumbar disc herniation. The present study extends the follow-up period to 3 years in 19 of the 25 original patients. Clinical examinations, lateral plain x-rays, and CT scans without contrast enhancement of the operated disc were repeated. The results indicate a decrease or even a disappearance of the hyperdense extradural material thought to represent fibrosis. An image suggestive of persistent disc herniation was still present in 5 of 8 patients with this finding on early postoperative CT scans. Persistent intradiscal gas was seen in nearly half of the patients. Total normalization of the posterior extraspinal structures was the rule. There was no correlation between CT appearance and residual complaints of the patients. CT scans without contrast enhancement may be sufficient to guide the surgeon in postoperative patients with massive signs and symptoms of recurrent root compression in whom a second operation is indicated on clinical grounds. In all other cases, myelography followed by CT scans is considered appropriate to investigate failed back surgery syndrome. (Neurosurgery 29:1-7, 1991)

scholarly journals A Rare Case of Spinal Subdural Hematoma Complicating Minimally Invasive Lumbar Micro Discectomy and Decompression for Recurrent Lumbar Disc Herniation

2019 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Failed Back Surgery Syndrome ◽  
Neurological Deficits ◽  
Unusual Complication ◽  
Lumbar Region ◽  
Failed Back Surgery ◽  
Spinal Subdural Hematoma ◽  
Recurrent Lumbar Disc Herniation

Spinal subdural hematomas is a very rare and unusual complication of spinal interventions. We present a case of subacute SSDH in the lumbar region of a 60 year-old woman following microdiscectomy for recurrent lumbar disc herniation. By presenting this rarely seen case of postoperative subacute SSDH, we want to bring attention to the possible postoperative complications like spinal hematomas in the differential diagnosis of failed back surgery syndrome in patients who do not respond to conservative treatment or develop neurological deficits and to the importance of radiological imaging in such cases.

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