Perineal anesthesia following interlaminar endoscopic disc surgery.

Perineal anesthesia is defined as the loss of sensation to the area of buttocks, perianal space and thighs. It is often seen in cauda equina syndrome as a collection of acute symptoms mostly occurring secondary to a large disc herniations leading to neuropathy of multiple lumbar and sacral nerve roots. We present 30 years- old male patient who was admitted with sever left leg pain for over a month. On neurological examination a 3/5 plantarflexion paresis was observed on the left with hypoesthesia concordant to the S1 dermatome. A lumbar MRI showed a broad left L5-S1 disc herniation was detected. The patient underwent interlaminar endoscopic disc surgery and postoperatively, was relieved of his pain and a slightly improvement of his paresis was seen. On the first week follow-up he complained of anesthesia of his buttocks when sitting. On follow-up MRI, the disc was removed completely and no further pathologies could be seen. The patient continued physical therapy and on the 8th week postoperatively his paresis and perineal anesthesia resolved completely. Perineal anesthesia following endoscopic disc surgery was a complication we never have experienced at out clinic. Even when searching through medical databases we have not seen any reports in the literature in that way.