Symptomatic Postoperative Discal Pseudocyst After Percutaneous Endoscopic Interlaminar Discectomy: Case Report and Literature Review

Orthop Surg. 2021 Feb;13(1):347-352. doi: 10.1111/os.12863. Epub 2020 Dec 16.

Abstract

Background: A postoperative discal pseudocyst (PDP) is a cystic lesion that is formed in the operation area of the intervertebral disc, leading to recurrence or even worse symptoms. To our knowledge, to date, there is no research focusing specifically on PDP following percutaneous endoscopic interlaminar discectomy (PEID).

Case presentation: We present the case of a 27-year-old man with L5 S1 intervertebral disc herniation who was treated with PEID after failed conservative treatment. His leg pain was relieved immediately but reoccurred on the 40th day. MRI showed a PDP. Because loxoprofen and bedrest were ineffective and the patient was anxious, we performed a cystectomy. The patient's symptoms were significantly relieved, and a 6-month follow up showed no recurrence both clinically and on MRI.

Conclusion: A PDP is more likely to form using the interlaminar approach than the transforaminal approach. For patients with mental stress, severe pain, and neurological symptoms, surgery is suggested to remove the cyst. Discectomy cannot be performed when disc degeneration is mild.

Keywords: Percutaneous endoscopic interlaminar discectomy; Postoperative discal pseudocyst; Surgical treatment.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Cystectomy / methods*
  • Cysts / etiology
  • Cysts / surgery*
  • Diskectomy, Percutaneous / methods*
  • Endoscopy / methods*
  • Humans
  • Intervertebral Disc Degeneration / surgery*
  • Intervertebral Disc Displacement / surgery*
  • Lumbar Vertebrae / surgery*
  • Male
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery*
  • Reoperation / methods

Supplementary concepts

  • Intervertebral disc disease