The Limitation of Endoscopic Surgery Using the Full Endoscopic Discectomy System for the Treatment of Destructive Stage Pyogenic Spondylodiscitis: A Case Series

Figure 3

A 77-year-old male had severe back pain and could not sit for a long time due to pyogenic spondylodiscitis at the L4/L5 level. He underwent surgery with FED; however, not only did the postoperative pain scale scores remain unchanged, but also left thigh pain and quadriceps muscle weakness also appeared. He underwent anterior spinal fusion with an iliac strut autograft 13 days after FED. After the revision surgery, low back pain and neurological disorder improved. (a) Preoperative sagittal CT scan images showing destructive changes, including narrowing of disc height and destruction of the endplate at the L4/L5 level, although the foraminal sagittal view did not show foraminal stenosis (arrow). (b) Foraminal sagittal CT scan view after FED showing the progress of vertebral destruction and stenosis of the foramen (arrow). (c) Sagittal CT scan images showing regained foraminal space (arrow) after open surgery with anterior strut autograft.

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