Interventionist performs a "sham" lumbar microdiscectomy should interventionalists be performing spinal surgery
Ghaly RF, Perciuleac Z, Candido KD, Knezevic NN. Interventionist performs a "sham" lumbar microdiscectomy: Should interventionalists be performing spinal surgery? Surg Neurol Int. 2020 Dec 29;11:467. doi: 10.25259/SNI_672_2020. PMID: 33500805; PMCID: PMC7827464
Background: Neurosurgeons and orthopedists, who have received specific training, should be the ones performing spinal surgery. Here, we present a case in which spinal surgeons secondarily (e.g., 6 months later) found that a patient's first lumbar discectomy, performed by an interventional specialist, had been a "sham" procedure.
Case Description: A 30-year-old male presented with sciatica attributed to a magnetic resonance imaging documented large, extruded disc at the L4-5 level. An interventional pain management specialist (IPMS) performed two epidural steroid injections; these resulted in an exacerbation of his pain. The IPMS then advised the patient that he was a surgeon and performed an "interventional" microdiscectomy. Secondarily, 6 months later, when the patient presented to a spinal neurosurgeon with a progressive cauda equina syndrome, the patient underwent a bilateral laminoforaminotomy and L4-L5 microdiscectomy. Of interest, at surgery, there was no evidence of scarring from the IPMS' prior "microdiscectomy;" it had been a "sham" operation. Following the second surgery, the patient's cauda equina syndrome resolved.
Conclusion: IMPS, who are not trained as spinal surgeons should not be performing spinal surgery/ microdiscectomy.