J Minim Invasive Spine Surg Tech.  2020 Oct;5(2):72-75. 10.21182/jmisst.2020.00122.

Epidural Migration of Dervan Platelet Fibrin Plug Causing Recurrent Sciatica: A Case Report

• Mahesha K

• KMID: 2562067
• DOI: http://doi.org/10.21182/jmisst.2020.00122

Abstract

A 40-year-old male presented with right sided sciatica due to L3-L4 disc prolapse. Patient was treated with transforaminal endoscopic discectomy L3-L4 and platelet fibrin plug application under local anaesthesia. Patient had good relief from pain after the procedure. At one month after the surgery, patient developed recurrent sciatica. Magnetic resonance imaging revealed recurrent compression at the operated level. Patient was treated with repeat transforaminal endoscopic surgery. Transforaminal endoscopy revealed epidural migration of the platelet fibrin plug and was removed. Patients had immediate relief from radicular pain with no further recurrence. Histopathology report confirmed that it was migrated platelet fibrin plug. As the platelet fibrin plug does not have any fixation in the disc, it carries a significant risk of epidural migration and recurrent sciatica.

Keyword

Disc prolapse; Platelet rich fibrin; Transforaminal endoscopy