Nerve root herniation with entrapment in the facet joint gap after lumbar decompression surgery: a case presentation

Background An incidental dural tear is a well-known complication during spine surgery. A rare consequence is a postoperative nerve root herniation. The purpose of this report is to describe a case of such a herniation with entrapment in the facet gap joint and to present the first MR images of this rare surgical complication. Case presentation We report a case of a patient who underwent lumbar decompression surgery and afterwards suffered a sudden intractable sciatica. Postoperative MRI showed a new facet joint gap effusion. During revision surgery an entrapped nerve root was found in the facet joint gap. In retrospective, the herniated nerve root is visible on postoperative MRI. Conclusion This case report highlights a rare complication during spine surgery. This finding is important as signs suggestive for nerve root herniation can easily be overlooked on MRI. Furthermore, this represents the first MRI documentation of this complication.

Automated summary

This report describes a rare case of postoperative nerve root herniation following spine surgery, with the first MRI documentation of this complication. The entrapped nerve root was found in the facet joint gap during revision surgery, highlighting the importance of careful evaluation of MRI images for signs of nerve root herniation.