• Shigeru Kobayashi, Kenzo Uchida, Kenichi Takeno, Takafumi Yayama, Hideaki Nakajima, Eiki Nomura, Katsuhiko Hayakawa, Adam Meir, Takumi Yonezawa, and Hisatoshi Baba.
• Department of Orthopaedics and Rehabilitation Medicine, Fukui University School of Medicine, Fukui, Japan. kshigeru@fmsrsa.fukui-med.ac.jp
• Neurosurgery. 2007 Feb 1; 60 (2 Suppl 1): ONSE171-2; discussion ONSE172.

ObjectiveIn recent years, percutaneous laser disc decompression (PLDD) has become a routine surgical procedure because it can be performed under local anesthesia and is minimally invasive. However, there is a risk of nerve root and endplate injury owing to heat generated by laser irradiation during PLDD. We recently performed salvage surgery on a patient with heat injury to the L5 nerve root that developed after PLDD.Clinical PresentationOne month before presenting to our hospital, the patient underwent two sessions of PLDD for lumbar vertebral disk herniation at another institution. The patient developed worsening sciatica, as well as bowel and urinary problems after the PLDD.InterventionWe performed salvage surgery after PLDD. The intraoperative findings in the present case included carbon spots in the dura mater of the nerve root and a disc herniation strongly adherent to the nerve roots. These findings indicate that the area adjacent to the nerve roots was damaged by excessive heat during laser irradiation.ConclusionWhen salvage surgery is performed after a PLDD procedure, disc and nerve root injuries owing to laser heat energy must be considered.

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