Postoperative Transient Neurogenic Claudication After Lumbar Endoscopic Decompression: The Role of Floseal in Minimally Invasive Spine Surgery

The shift toward minimally invasive procedures in American healthcare has transformed spine surgery, particularly with the rise of endoscopic techniques. Endoscopic spine surgery enables the treatment of conditions like lumbar spinal stenosis, offering advantages such as reduced tissue trauma, smaller incisions, and quicker recovery compared to traditional open surgery. Spinal stenosis, where the spinal canal narrows and compresses nerves, often results in significant pain, numbness, or weakness in the lower extremities. Despite the benefits of endoscopic decompression, it brings unique challenges, particularly regarding intraoperative bleeding control. Hemostatic agents, such as Floseal (Baxter, Deerfield, IL), a gelatin matrix, are commonly used to manage bleeding during surgery. However, their use in endoscopic procedures within confined spaces introduces considerations not seen in open surgeries. This case report presents a patient with lumbar stenosis who underwent endoscopic decompression and developed postoperative neurogenic claudication, illustrating both the outcome and the use of Floseal in minimally invasive spine surgeries.