Broken surgical blade retrieval following lumbar discectomy through paravertebral/lateral transpsoas approach: A case report

Barbero-Aznarez, Pablo; Bucheli-Peñafiel, Carlos; Olmos-Francisco, Eduardo; Lorente-Muñoz, Asís; Cortés-Franco, Severiano

doi:10.25259/sni_880_2020

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…The fractured instrument tip was finally removed using a pituitary disc rongeur and a Pennybacker probe dissector under fluoroscopic guidance. Other methods that have been mentioned for retrieval of the retained object include the paravertebral/lateral transpsoas approach, transforaminal approach, and robotic-assisted laparoscopy 6,17,18 .…”

Section: Discussionmentioning

confidence: 99%

Breakage of a Pituitary Rongeur Tip: An Unforeseen Complication of Lumbar Microdiscectomy

Ramachandran

Meena

Anand

et al. 2023

JBJS Case Connector

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Case: A 46-year-old man with left leg radiculopathy due to a left L4-5 disc extrusion had a lumbar microdiscectomy that was complicated by the pituitary rongeur tip breaking in the L4-5 disc space. The rongeur tip was successfully retrieved by widening the entry access without damaging the adjoining facet and utilizing a blunt nerve hook and probe dissector. Conclusion:Breakage of the pituitary rongeur tip is an unforeseen complication of lumbar microdiscectomy. Surgeons should be aware of this potential complication, ideally confirm the rongeur is intact prior to wound coverage, and understand the risks versus benefits of attempting to retrieve a broken rongeur tip. Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/C16).

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Section: Discussionmentioning

confidence: 99%

Breakage of a Pituitary Rongeur Tip: An Unforeseen Complication of Lumbar Microdiscectomy

Ramachandran

Meena

Anand

et al. 2023

JBJS Case Connector

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“…Relevant medical literature on such complications is scarce. Transforaminal, anterior-laparoscopic, posterior-endoscopic, and lateral approaches were used to retrieve broken scalpel blade fragments ( 3 , 10 , 12 , 15 ). The limitation of this study is that case reports are rare, making each case unique.…”

Section: Discussionmentioning

confidence: 99%

Anterior pushing technique for a broken scalpel blade in lumbar discectomy: a case report

Čeleš,

Gasparini,

Mohar

2023

Front. Surg.

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The presence of broken surgical blades or other surgically uncontrolled sharp and pointed objects in the disc space is a rare but potentially severe complication of posterior lumbar spine procedures. Herein, we report the case of a 59-year-old female patient with a history of lumbar decompression and interspinous process device implantation who underwent an instrumented revision of the lumbosacral junction. During the L5–S1 discectomy, the scalpel blade broke, and the broken fragment could not be retrieved through the posterior approach. With regard to the vascular anatomy, we partially pushed the fragment through the anterior annulus into the retroperitoneal space. In addition, pedicle screws were locked to ensure the stability of the construct. The fractured blade fragment was eventually removed by laparoscopy 1 week after the initial procedure. This experience suggests that the anterior pushing technique with fluoroscopy is an option in rare cases where a broken scalpel blade cannot be reached through the posterior approach. In such cases, computed tomography angiography is recommended.

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“…The extended extraforaminal approach which was utilized in the current case provides a large visual field which might obviate the necessity of a pars removal as well as the offending instrumentation (Figure 4). In 2021, Barbero-Aznarez et al successfully employed the paravertebral transposition approach for this purpose [10]. We believe that in the majority of cases, with consideration given for the familiarity of the neurosurgeons; the broken blade can nearly always be retrieved via one of these posterior corridors.…”

Section: Plain Language Summarymentioning

confidence: 98%

Retained Lumbar Intradiscal Surgical Knife Blade Retrieved Via Extended Extraforaminal Approach: Case Report and Review

et al. 2021

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Background and Importance: During a lumbar discectomy, the surgical knife might be broken and embedded deeply within the disc space. In some cases, it may be impossible to remove the broken blade during the initial surgery despite allocating several hours for this purpose. This fact may justify a subsequent surgical session. However, the eventual retrieval of the broken scalpel during a second surgical encounter can likewise be a very daunting challenge. Case Presantation: An L4-L5 discectomy in a young boy was complicated by the presence of an intradiscal broken surgical knife blade. The broken blade was successfully retrieved in a subsequent surgical session via the extended extraforaminal approach. Conclusion: The occurrence of an intradiscal retained broken scalpel has been rarely discussed within medical literature. There exist a wide variety of different approaches used for such a needed retrieval. The extended extraforaminal corridor has yet to be described within the context of medical journalism.

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Broken surgical blade retrieval following lumbar discectomy through paravertebral/lateral transpsoas approach: A case report

Cited by 4 publications

References 4 publications

Breakage of a Pituitary Rongeur Tip: An Unforeseen Complication of Lumbar Microdiscectomy

Breakage of a Pituitary Rongeur Tip: An Unforeseen Complication of Lumbar Microdiscectomy

Anterior pushing technique for a broken scalpel blade in lumbar discectomy: a case report

Retained Lumbar Intradiscal Surgical Knife Blade Retrieved Via Extended Extraforaminal Approach: Case Report and Review

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