Skip to main content

Advertisement

SpringerLink
Log in

Postoperative dysesthesia in minimally invasive transforaminal lumbar interbody fusion: a report of five cases

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Objective

Minimally invasive transforaminal lumbar interbody fusion (misTLIF) can potentially lead to dorsal root ganglion (DRG) injury which may cause postoperative dysesthesia (POD). The purpose of retrospective study was to describe the uncommon complication of POD in misTLIF.

Methods

Between January 2010 and December 2014, 539 patients were treated with misTLIF in investigator group. POD was defined as dysesthetic pain or burning dysesthesia at a proper DRG innervated region, whether spontaneous or evoked. Non-steroidal antiinflammatory drugs, central non-opioid analgesic agent, neuropathic pain drugs and/or intervertebral foramen block were selectively used to treat POD.

Results

There were five cases of POD (5/539, 0.9 %), which consisted of one patient in recurrent lumbar disc herniation (1/36, 3 %), one patient in far lateral lumbar disc herniation (1/34, 3 %), and 3 patients in lumbar spondylolisthesis (3/201, 1 %). Two DRG injury cases were confirmed by revision surgery. After the treatment by drugs administration plus DRG block, all patients presented pain relief with duration from 22 to 50 days. A gradual pain moving to distal end of a proper DRG innervated region was found as the beginning of end.

Conclusions

Although POD is a unique and rare complication and maybe misdiagnosed as nerve root injury in misTLIF, combination drug therapy and DRG block have an effective result of pain relief. The appearance of a gradual pain moving to distal end of a proper DRG innervated region during recovery may be used as a sign for the good prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Fan S, Zhao X, Zhao F, Fang X (2010) Minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases. Spine 35:1615–1620

    Article  Google Scholar 

  2. Peng CW, Yue WM, Poh SY, Yeo W, Tan SB (2009) Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion. Spine 34:1385–1389

    Article  PubMed  Google Scholar 

  3. Scheufler KM, Dohmen H, Vougioukas VI (2007) Percutaneous transforaminal lumbar interbody fusion for the treatment of degenerative lumbar instability. Neurosurgery 60(4 suppl 2):203–213

    PubMed  Google Scholar 

  4. Schizas C, Tzinieris N, Tsiridis E, Kosmopoulos V (2009) Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience. Int Orthop 33:1683–1688

    Article  PubMed  PubMed Central  Google Scholar 

  5. Wu RH, Fraser JF, Härtl R (2010) Minimal access versus open transforaminal lumbar interbody fusion. Spine 35(26):2273–2281

    Article  PubMed  Google Scholar 

  6. Rodríguez-Vela J, Lobo-Escolar A, Joven E, Muñoz-Marín J, Herrera A, Velilla J (2013) Clinical outcomes of minimally invasive versus open approach for one-level transforaminal lumbar interbody fusion at the 3- to 4-year follow-up. Eur Spine J 22(12):2857–2863

    Article  PubMed  PubMed Central  Google Scholar 

  7. Phan K, Rao PJ, Kam AC, Mobbs RJ (2015) Minimally invasive versus open transforaminal lumbar interbody fusion for treatment of degenerative lumbar disease: systematic review and meta-analysis. Eur Spine J 24(5):1017–1030

    Article  PubMed  Google Scholar 

  8. Adogwa O, Parker SL, Bydon A, Cheng J, McGirt MJ (2011) Comparative effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion: 2-year assessment of narcotic use, return to work, disability, and quality of life. J Spinal Disord Tech 24:479–484

    PubMed  Google Scholar 

  9. McGirt MJ, Parker SL, Lerner J, Engelhart L, Knight T, Wang MY (2011) Comparative analysis of perioperative surgical site infection after minimally invasive versus open posterior/transforaminal lumbar interbody fusion: analysis of hospital billing and discharge data from 5170 patients. Clinical article. J Neurosurg Spine 14:771–778

    Article  PubMed  Google Scholar 

  10. Parker SL, Adogwa O, Bydon A, Cheng J, McGirt MJ (2012) Cost effectiveness of minimally invasive versus open transforaminal spondylolisthesis associated low-back and leg pain over 2 years. World Neurosurg 78:178–184

    Article  PubMed  Google Scholar 

  11. Parker SL, Adogwa O, Witham TF, Aaronson OS, Cheng J, McGirt MJ (2011) Post-operative infection after minimally invasive versus open transforaminal lumbar interbody fusion (TLIF): literature review and cost analysis. Minim Invasive Neurosurg 54:33–37

    Article  CAS  PubMed  Google Scholar 

  12. Dhall SS, Wang MY, Mummaneni PV (2008) Clinical and radiographic comparison of mini-open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up. J Neurosurg Spine 9:560–565

    Article  PubMed  Google Scholar 

  13. Wong AP, Smith ZA, Stadler JA 3rd, Hu XY, Yan JZ, Li XF, Lee JH, Khoo LT (2014) Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF): surgical technique, long-term 4-year prospective outcomes, and complications compared with an open TLIF cohort. Neurosurg Clin N Am 25(2):279–304

    Article  PubMed  Google Scholar 

  14. Wang J, Zhou Y (2014) Perioperative complications related to minimally invasive transforaminal lumbar fusion: evaluation of 204 operations on lumbar instability at single center. Spine J 14(9):2078–2084

    Article  PubMed  Google Scholar 

  15. Wu WJ, Liang Y, Zhang XK, Cao P, Zheng T (2012) Complications and clinical outcomes of minimally invasive transforaminal lumbar interbody fusion for the treatment of one- or two-level degenerative disc diseases of the lumbar spine in patients older than 65 years. Chin Med J 125(14):2505–2510

    PubMed  Google Scholar 

  16. Lau D, Lee JG, Han SJ, Lu DC, Chou D (2011) Complications and perioperative factors associated with learning the technique of minimally invasive transforaminal lumbar interbody fusion (TLIF). J Clin Neurosci 18(5):624–627

    Article  PubMed  Google Scholar 

  17. Yeung AT, Tsou PM (2002) Posterolateral endoscopic escision for lumbar disc herniation: surgical technique, outcome, and complication in 307 consecutive cases. Spine 27:722–731

    Article  PubMed  Google Scholar 

  18. Retten S, Komp M, Merk H, Godolias G (2007) Use of newly developed instruments and endoscopes: full-endoscopic resection of lumbar disc herniation via the interlaminar and lateral transforaminal approach. J Neurosurg Spine 6:521–530

    Article  Google Scholar 

  19. Ruetten S, Komp M, Merk H, Godolias G (2008) Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine 33:931–939

    Article  PubMed  Google Scholar 

  20. Hara ES, Matsuka Y, Minakuchi H, Clark GT, Kuboki T (2012) Occlusal dysesthesia: a qualitative systematic review of the epidemiology, aetiology and management. J Oral Rehabil 39(8):630–638

    Article  CAS  PubMed  Google Scholar 

  21. Kikuchi S, Sato K, Konno S, Hasue M (1994) Anatomic and radiographic study of dorsal root ganglia. Spine 19:6–11

    Article  CAS  PubMed  Google Scholar 

  22. Moon HS, Kim YD, Song BH, Cha YD, Song JH, Lee MH (2010) Position of dorsal root ganglia in the lumbosacral region in patients with radiculopathy. Korean J Anesthesiol 59(6):398–402

    Article  PubMed  PubMed Central  Google Scholar 

  23. Hoss D, Segal S (1998) Scalp dysesthesia. Arch Dermatol 134(3):327–330

    Article  CAS  PubMed  Google Scholar 

  24. Thoppay JR, De Rossi SS, Ciarrocca KN (2013) Burning mouth syndrome. Dent Clin North Am 57(3):497–512

    Article  PubMed  Google Scholar 

  25. Krishna M, Pollock RD, Bhatia C (2008) Incidence, etiology, classification, and management of neuralgia after posterior lumbar interbody fusion surgery in 226 patients. Spine J 8:374–379

    Article  PubMed  Google Scholar 

  26. Kalia LV, O’Connor PW (2005) Severity of chronic pain and its relationship to quality of life in multiple sclerosis. Mult Scler 11(3):322–327

    Article  PubMed  Google Scholar 

  27. Grøvle L, Haugen AJ, Natvig B, Brox JI, Grotle M (2013) The prognosis of self-reported paresthesia and weakness in disc-related sciatica. Eur Spine J 22(11):2488–2495

    Article  PubMed  PubMed Central  Google Scholar 

  28. Choi I, Ahn JO, So WS, Lee SJ, Choi IJ, Kim H (2013) Exiting root injury in transforaminal endoscopic discectomy: preoperative image considerations for safety. Eur Spine J 22(11):2481–2487

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, 183 Xinqiao Street, Shapingba District, Chongqing, 400037, China

    Honggang Wang, Yue Zhou & Zhengfeng Zhang

Authors
  1. Honggang Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yue Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhengfeng Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Yue Zhou or Zhengfeng Zhang.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, H., Zhou, Y. & Zhang, Z. Postoperative dysesthesia in minimally invasive transforaminal lumbar interbody fusion: a report of five cases. Eur Spine J 25, 1595–1600 (2016). https://doi.org/10.1007/s00586-015-4365-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-015-4365-4

Keywords

Search

Navigation