In Response to Letter Re: Postoperative Longitudinal Outcomes in Patients with Residual Disc Fragments

摘要

We read with interest the article ‘‘Postoperativelongitudinal outcomes in patients with residual discfragments after percutaneous endoscopic lumbar discectomy” by Baek et al (1). The authors first comparedthe longitudinal clinical outcomes of percutaneousendoscopic lumbar discectomy (PELD) patients to thecomplete group and the residual group. However, it isreally disputable that they would divide patients intogroups using the magnetic resonance imaging (MRI)within 24 hours postoperatively. Different from thetraditional open or microendoscopic discectomy, PELDis performed under continuous saline irrigation. Theevaluation of neural decompression is likely to be affected by residual fluid and the adjacent edematous tissue, especially within 24 hours postoperatively. In thepresented case, preoperative sagittal T2-weighted MRIshowed a herniated lumbar disc that migrated inferiorly from L5-S1. The “residual disc fragments” remainedat S1 at the MRI immediately following the procedure,which was completely resorbed at the 6-month followup MRI (Fig. 1).