Lumbar discitis complicating percutaneous laser disc decomposition: case report and review of literature.

Percutaneous methods for treating herniated lumbar discs are relatively new procedures and include chemonucleolysist, automated discectomy and laser disc decompression3,4. The advantages of these procedures are minimal invasion and complications. However, discitis, bowel nerve root and great vessel injuries have been reported. Although chymopapain injected into the intervertebral discs, employed in more than 16,000 patients, was withdrawn following a double-blind study that indicated that the enzyme had no significant benefit over its diluent; enthusiasm for percutaneous lumbar discectomy utilizing an automated neucleotome or Nd: YAG laser still exists in certain centres. The rationale for these procedures is that by removing a small portion of the nucleus, one reduces the intradiscal pressure. The validity of these procedures as safer and less invasive alternative to open discectomy/laminectomy has not been proved and in the absence of a well designed, prospective randomized study, itwouldbepnidentto regard this entire area of surgery with appropriate skepticism. In this report, a disabling complication of laser discectomy is presented.