Postoperative discal cyst: An unusual complication after microendoscopic discectomy in teenagers

Abstract

Various complications after microendoscopic discectomy (MED) are well known, but postoperative discal cyst is a unique and relatively unknown complication. Here, we report on two teenage patients who presented with postoperative discal cyst after MED for herniated nucleus pulposus (HNP), which resolved after conservative treatment. The patients were diagnosed with HNP at L4-5 and L5-S1 based on MRI and then treated by MED. Postoperative discal cyst was diagnosed on MRI after recurrence of symptoms. Both patients were managed conservatively. T2-weighted MRI demonstrated hyperintense collections adjacent to the operated intervertebral disc level, which were communicating with the corresponding disc annulus. Because the clinical symptoms were relatively mild, the patients were managed conservatively; both made a complete clinical recovery with radiological evidence of improvement. Postoperative discal cyst is a relatively unknown complication after MED for HNP. Surgeons should be aware of this postoperative complication when operating on young individuals with HNP.

A Rare Case of a Discal Cyst Following Percutaneous Endoscopic Lumbar Discectomy via a Transforaminal Approach

“…Although discal cysts have been reported to occur in the intraspinal extraepidural area, 1,2,5 this is a rare case caused by the entry pathway of the PED on the intervertebral disc. The pathogenesis and etiology are still unclear.…”

“…Several reports have described discal cysts occurring after lumbar discectomy via posterior approaches, such as conventional open discectomy, the technique described by Love, or microendoscopic discectomy. [2][3][4] Here, we report the rare case of a discal cyst that developed after percutaneous endoscopic lumbar discectomy (PED) via a transforaminal approach.…”

Symptomatic postoperative discal pseudocyst following percutaneous endoscopic lumbar discectomy

“…Conservative treatment: Subash [ 12 ] reported that 2 patients under the age of 20 experienced low back pain and leg pain after MED. After MRI, the patients were diagnosed with PDP.…”

Discal Cyst: a Rare Cause of Neurologic Compression in the Young Adult

“…Chiba et al 4 hypothesized that an epidural hematoma is initially formed from hemorrhage of the epidural venous plexus that occurs in the space between the peridural membrane and the vertebral body, and discal cysts form most likely as a consequence of impairment of hematoma resorption. As also, Murata et al 16 studied a case and hypothesis that the haemorrhage of the epidural venous plexus caused by separation of the peridural membrane.…”