The operative failures and complications of percutaneous posterolateral
lumbar discectomy were analyzed in 100 patients who had a herniated nucleus
pulposus and were prospectively studied and treated with use of a
6.9-millimeter outer-diameter (4.9-millimeter inner-diameter) sheath and
manual insertion of the instruments. Twelve operations were considered to
have failed, regardless of the length of postoperative follow-up or the
incidence of reinjury; eleven patients had a repeat operation at the index
level, and one patient was a chronic drug-abuser. In eight of the eleven
patients, subsequent laminectomy was successful. Two patients had a psoas
hematoma and one had a transitory sensory and distal motor deficit; all of
these complications resolved without sequelae. There were no major
complications, including superficial or deep infection, and no patient had
neurovascular compromise.