Two cases of retroperitoneal hematoma after transforaminal percutaneous endoscopic lumbar discectomy

Abstract

Introduction: Transforaminal percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive spinal procedure for soft disc herniation of the lumbar spine. It is considered relatively safe and is commonly used. However, hemorrhagic complications can occur. Herein, we report two cases of severe retroperitoneal bleeding after transforaminal PELD. Case reports: Two patients underwent PELD at the L4-5 level, and the preoperative symptoms improved. However, a few hours after the surgery, the patients complained of severe abdominal pain. Radiologic evaluation showed a large retroperitoneal hematoma compressing the abdominal organs. Results: The patients did not undergo an open hematoma evacuation but received intensive care. After 9–14 days of intensive care, they recovered and were discharged. Conclusion: Retroperitoneal hematoma may occur after PELD due to segmental artery perforation. The spinal needle should be manipulated carefully. Even for large hematomas, conservative treatment is possible in select patients. Keywords: Retroperitoneal hematoma, PELD, Percutaneous endoscopic lumbar discectomy, Complication