1. Complications of Endoscopic Lumbar Discectomy 안광준, 최우진, 김관태 허리사랑병원

2. Data of hurisarang hospital Period :2005. 2 ~ 2006.8 ( 1 년 6 개월 ) Cases : 418 endoscopic discectomy

3. Cases ( N=418 ) L5-S1L4-L5L3-L4L2-L3L1-L2 ILD145 21 2 0 0168 PLD 10195 30 12 3250 155216 32 12 3418 ILD: interlaminar approach, PLD: posterolateral approach

4. Complications Vascular injury Neural injury Dura tear ( CSF leakage ) Infection Recurrence Etc

5. 1. Anterior Vessel injury Incidence 0.045% / open surgery 0% / survey period

6. Avoidance Confirm always needle placement 9 inches C-arm : lateral view is more safe than AP

7. 31/F, huge HNP L4-5 Rt preop postop

8. Very thin case : careful !

9. 2. Nerve injury Incidence 0.2% / open surgery 0.2% / survey period

10. Avoidance Adhesion Compression Shallow Anesthesia

11. Case

12. 3. Dura tear Incidence 7.2% - 0.8% / open surgery 0.9% / survey period

13. Avoidance Adhesion Don ’ t Worry

14. Case 29/ M recurred HNP L5-S1 Lt.

15. 4. infection Incidence 0.13% - 0.9% / open surgery 0.4% /survey period

16. Infection type Aseptic discitis > septic discitis

17. Avoidance + remove debris

18. Case 56/M, HNP L3-4 Rt. Upward,PreOP.

19. Post Op. MRI

20. POD # 12

21. 5. Recurrent disc prolapse Incidence 5-7% / open surgery 3.1% / survey period

22. Avoidance < Recommend Remove sufficient disc Use gelfoam ?

23. Conclusion Vascular injury : lateral view Neural injury : shallow anesthesia Dura tear ( CSF leakage): don ’ t worry Infection : debris Recurrence : Remove sufficient disc

24. 대단히 감사합니다.