Background: Percutaneous intradiscal hydrogel injection has been used to treat low-back pain (LBP) due to degenerative disc disease with or without mild radicular pain. Complications from these procedures are underreported. In this case lesson, the authors present a rare case of a patient with herniated intradiscal hydrogel following a minor trauma leading to neurological injury.
Observations: A 36-year-old female who had been previously treated with L4-5 and L5-S1 intradiscal hydrogel injections for LBP presented with painful, progressive right-sided lower-extremity weakness after experiencing a twisting trauma. Cross-sectional imaging results revealed a herniated hydrogel-based disc implant in the spinal canal. She underwent an urgent L4-5 laminectomy for decompression and removal of the herniated implant. A large annular defect was noted. Postoperatively, she had resolution of her right leg pain but experienced persistent right foot drop requiring an ankle-foot orthosis.
Lessons: Herniated intradiscal hydrogel implants can lead to permanent neurological injury. While the risk factors for hydrogel herniation have not been elucidated, they can be related to pre-existing disruptions to the annulus and/or posterior longitudinal ligament, excess volume of hydrogel injection, and insufficient fixation time. Further research is needed to determine the safety and efficacy of this technology. https://thejns.org/doi/10.3171/CASE24394.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616144 | PMC |
http://dx.doi.org/10.3171/CASE24394 | DOI Listing |
J Neurosurg Case Lessons
December 2024
Section of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Background: Percutaneous intradiscal hydrogel injection has been used to treat low-back pain (LBP) due to degenerative disc disease with or without mild radicular pain. Complications from these procedures are underreported. In this case lesson, the authors present a rare case of a patient with herniated intradiscal hydrogel following a minor trauma leading to neurological injury.
View Article and Find Full Text PDFGels
September 2024
Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University, 89081 Ulm, Germany.
Biomaterials, such as hydrogels, have an increasingly important role in the development of regenerative approaches for the intervertebral disc. Since animal models usually resist biomaterial injection due to high intradiscal pressure, preclinical testing of the biomechanical performance of biomaterials after implantation remains difficult. Papain reduces the intradiscal pressure, creates cavities within the disc, and allows for biomaterial injections.
View Article and Find Full Text PDFResearch (Wash D C)
February 2024
Department of Orthopedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
While mesenchymal stem cell (MSC) shows great potentials in treating intervertebral disc degeneration, most MSC die soon after intradiscal transplantation, resulting in inferior therapeutic efficacy. Currently, bulk hydrogels are the common solution to improve MSC survival in tissues, although hydrogel encapsulation impairs MSC migration and disrupts extracellular microenvironment. Cell hydrogel encapsulation has been proposed to overcome the limitation of traditional bulk hydrogels, yet this technique has not been used in treating disc degeneration.
View Article and Find Full Text PDFAdv Healthc Mater
October 2024
Department of Orthopaedic Surgery, McKay Orthopaedic Research Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Injectable hydrogels offer minimally-invasive treatment options for degenerative disc disease, a prevalent condition affecting millions annually. Many hydrogels explored for intervertebral disc (IVD) repair suffer from weak mechanical integrity, migration issues, and expulsion. To overcome these limitations, an injectable and radiopaque hyaluronic acid granular hydrogel is developed.
View Article and Find Full Text PDFJ Vasc Interv Radiol
January 2024
Interventional Radiology, Cediul Imagenes Diagnostics Y Terapeuticas, Barranquilla, Columbia.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!