BACKGROUND
Postoperative discal pseudocyst (PDP) is a rare condition that presents after surgery for lumbar disc herniation. Due to the lack of information, the diagnosis and treatment of PDP remain controversial. Herein, we report a PDP case that occurred following percutaneous endoscopic lumbar discectomy and received conservative treatment. Additionally, we review all the published literature regarding PDP and propose our hypothesis regarding PDP pathology.
CASE SUMMARY
A 23-year-old man presented with a relapse of low back pain and numbness in his left lower extremity after undergoing percutaneous endoscopic lumbar discectomy for lumbar disc herniation. Repeat magnetic resonance imaging demonstrated a cystic lesion at the surgical site with communication with the inner disc. The patient was diagnosed as having PDP. The patient received conservative treatment, which resulted in rapid improvement and spontaneous regression of the lesion, and had a favorable outcome in follow-up.
CONCLUSION
PDP and discal cyst (DC) exhibit similarities in both histological and epidemiological characteristics, which indicates the same pathological origin of PDP and DC. The iatrogenic annular injury during discectomy might accelerate the pathological progression of DC. For patients with mild to moderate symptoms, conservative treatment can lead to great improvement, even inducing spontaneous regression. However, surgical cystectomy is necessary in patients with neurological deficits and where conservative treatment is ineffective.
[1]First Hosp Jilin Univ, Dept Spine Surg, 1 Xinmin St, Changchun 130021, Jilin, Peoples R China.
[2]Jilin Univ, Dept Spine Surg, China Japan Union Hosp, Changchun 130021, Jilin, Peoples R China.
[3]First Hosp Jilin Univ, Dept Pediat Surg, Changchun 130021, Jilin, Peoples R China.
[4]First Hosp Jilin Univ, Dept Traumatol, Changchun 130021, Jilin, Peoples R China.
[5]Jilin Engn Res Ctr Spine & Spinal Cord Injury, Dept Spine Surg, Changchun 130021, Jilin, Peoples R China.
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