Complications of Endoscopic Lumbar Discectomy 안광준, 최우진, 김관태 허리사랑병원

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

Cases ( N=418 ) L5-S1L4-L5L3-L4L2-L3L1-L2 ILD PLD ILD: interlaminar approach, PLD: posterolateral approach

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

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

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

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

Very thin case : careful !

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

Avoidance Adhesion Compression Shallow Anesthesia

Case

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

Avoidance Adhesion Don ’ t Worry

Case 29/ M recurred HNP L5-S1 Lt.

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

Infection type Aseptic discitis > septic discitis

Avoidance + remove debris

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

Post Op. MRI

POD # 12

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

Avoidance < Recommend Remove sufficient disc Use gelfoam ?

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

대단히 감사합니다.