Epidural Fluid Collection after Percutaneous Endoscopic Lumbar Discectomy.

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Epidural Fluid Collection after Percutaneous Endoscopic Lumbar Discectomy.

World Neurosurg. 2018 Jan 04;:

Authors: Liu WC, Choi G, Lee SH, Kwon AM, Kim KH, Park J, Park HS

Abstract
OBJECTIVE: The frequency and extent of epidural fluid collection after percutaneous endoscopic lumbar discectomy (PELD) have not been previously described. The purpose of this study was to evaluate the significance of epidural fluid collection after PELD.
METHODS: From March 2008 to November 2015, immediate post-operative magnetic resonance (MR) images of 464 consecutive patients, comprising 284 men and 180 women, were obtained after PELD. The mean age of the patients at the time of admission was 43.1 years, ranging from 18 to 81 years. We also performed 24-h follow-up MR imaging after PELD in 35 patients to evaluate the morphologic changes on epidural fluid collection and to identify whether the collection was due to saline accumulation or cerebrospinal fluid leak.
RESULTS: The level of disc herniation was at L4-5, L5-S1, L3-4, and L2-3 in 245 (52.8%), 173 (37.3%), 37 (8.0%), and 9 (1.9%) patients, respectively. Of 464 patients, 418 (90.1%) had abnormal epidural fluid collection, 404 (84.7%) patients had ventral epidural fluid collection, 393 (84.7%) patients had dorsal epidural fluid collection, and 10 patients had epidural hematoma as per immediate post-operative MR imaging. According to the 24-h follow-up MR findings, 31 patients had epidural fluid collection; the epidural fluid collection in 29 patients (93.5%) resolved with time, and a minimal amount of fluid remained in two patients, but the lesion size decreased compared with that on the previous day.
CONCLUSION: Epidural fluid collection usually occurs after percutaneous endoscopic discectomy, which is mainly due to saline accumulation, which typically resolves with time, without treatment or complications.

PMID: 29307767 [PubMed - as supplied by publisher]

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