Postoperative discal pseudocyst caused by percutaneous endoscopic lumbar discectomy: two case reports and a literature review

Abstract

Postoperative discal pseudocyst (PDP) is a rare complication that can occur after percutaneous endoscopic lumbar discectomy (PELD), microendoscopic discectomy, and laminectomy. The PDP pathogenesis and pathological process remain unclear. We described two PDP cases following PELD, with long-term follow-up results. The first patient was an Asian male, 30 years old, who experienced unbearable low back pain with right lower limb radiating pain for 2 years. The second patient was also an Asian male, 21 years old, who experienced low back pain with bilateral lower limb numbness. Both patients were diagnosed with lumbar disc herniation, underwent PELD, and relapsed after discharge. The diagnosis was PDP in each case, and conservative treatment was initiated with oral anti-inflammatory drugs and rest. Eventually, the symptoms in both patients resolved. Magnetic resonance imaging showed that the discal cysts had disappeared. The follow-up of these two PDP cases after PELD showed good results, demonstrating that PDP may be a self-healing disease. Conservative treatment is effective, and surgery should be performed only in an emergency. These case reports and literature review can help improve the understanding of PDP.