Critical failure of a percutaneous discectomy probe requiring surgical removal during disc decompression

Abstract

Objective: We report a complication while performing a percutaneous disc decompression at the L4-L5 level using a Dekompressor Percutaneous Discectomy Probe.

Case report: A 54-year-old male was referred to the pain clinic for possible percutaneous disc decompression. For the procedure the Dekompressor unit was inserted over the stylette and a percutaneous disc decompression was performed for 1 to 2 minutes using the channeling technique. Approximately (3/4) mL of disc nucleus was successfully removed. Upon withdrawal of the Dekompressor unit, it was noted that the probe was no longer connected to the device handle. Fluoroscopic imaging showed that approximately 4 inches of the probe remained in the patient and that the auger's distal end was still lodged in the disc. An incision was made, and the auger was successfully removed by a neurosurgeon.

Conclusions: The patient had an uneventful recovery. Manipulation of the auger should be performed in a linear motion as best as possible and under fluoroscopic guidance.