Complications of percutaneous lumbar extraforaminotomy

To achieve effective decompression of lumbar foraminal spinal stenosis by resecting foraminal ligaments, and to facilitate the spread of medication around the target nerve, specially designed instruments for percutaneous lumbar extraforaminotomy (PLEF) was invented to allow a minimally invasive procedure. The authors performed more than 2200 PLEFs, but did not experience any major complications other than one psoas hematoma and one nerve damage due to the physician's carelessness. Vasovagal reactions defining a subtype of syncope may lead to an interruption of the interventions. The best way to prevent the vasovagal reactions may be a suitable premedication before intervention and performing the intervention under sedation. Inadvertent intravascular injection of particulate corticosteroids can cause occlusion of small end arteries. Careful analysis of the imaging examination helps design the puncture route and avoid complications related to the instruments. Post-operative education about functional exercise is also important to stabilize the spine and reduce the possibility of sympomes.