Abstract
BackgroundPrevious research and published literature indicate that some patients with spinal diseases who underwent percutaneous transforaminal endoscopic decompression (PTED) still suffer some discomfort in the early recovery stage in the form of pain, stiffness, and swelling. These are usually considered minor residual symptoms or normal postoperative phenomenon (NPF) in the clinic, occur frequently, and are acknowledged by surgeons worldwide.To the best of our knowledge, we report the first case of a patient who had an osteoporotic vertebral fracture (OVF) misdiagnosed as NPF after she underwent PTED as a result of lumbar disc herniation (LDH).Case presentationA 71-year-old female with Parkinson’s disease who presented with lower back pain radiating to the legs was diagnosed as LDH in L4–5, after which a PTED of L4–5 was performed, with temporary alleviation of symptoms. However, severe lower back pain recurred. Unfortunately, the recurred pain initially misdiagnosed as NPF, in fact, was finally confirmed to be OVF by CT-scan. OVF in the early stage of post-PTED seldom occurs and is rarely reported in the literature.With a percutaneous vertebroplasty, the pain was significantly relieved, and she resumed walking. After 36-weeks of follow-up, the pain improved satisfactorily.ConclusionDoctors should not immediately diagnose a relapse of back pain following PTED as NPF, and hands-on careful physical and imaging examinations are necessary to manage recurring pain rightly and timely.
Highlights
Previous research and published literature indicate that some patients with spinal diseases who underwent percutaneous transforaminal endoscopic decompression (PTED) still suffer some discomfort in the early recovery stage in the form of pain, stiffness, and swelling
Parkinson’s disease (PD) is a neurodegenerative disorder that commonly occurs in the elderly, has a tendency to reduce bone mass, and is closely associated with osteoporotic vertebral fracture (OVF), which might be missed during clinical check-up or neglected as soft tissue impairment if in the absence of a clear trauma history [5]
The back pain vanished without recurrence, with the SF-36 score adding up to 353 and Japanese orthopedic association (JOA) 25 points at 14 weeks postoperative following the PTED of L4–5
Summary
Previous research and published literature indicate that some patients with spinal diseases who underwent percutaneous transforaminal endoscopic decompression (PTED) still suffer some discomfort in the early recovery stage in the form of pain, stiffness, and swelling. Conclusion: Doctors should not immediately diagnose a relapse of back pain following PTED as NPF, and hands-on careful physical and imaging examinations are necessary to manage recurring pain rightly and timely. We present a rare case of a patient with PD postPTED for degenerative lumbar disc herniation (LDH) who developed OVF during the early recovery stages, which seldom occurs and is rarely reported in literature.
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