Retained needle after cement injection during vertebral augmentation and its management strategy

A middle aged patient with multiple myeloma resulting in numerous pathological fractures underwent an L2, L3, and L5 vertebral cement augmentation for pain relief. After injection, the trocar at L2, the final level, could not be withdrawn despite several attempts of needle rotation, a second needle...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2016-02, Vol.2016, p.bcr2015012180
Main Authors: Kosse, Angelika, Nakhla, Jonathan Pishoi, Yassari, Reza, Abramowicz, Apolonia Elisabeth, Brook, Allan
Format: Article
Language:English
Subjects:
Bone Cements
Cement
Foreign Bodies - etiology
Foreign Bodies - surgery
Humans
Injections - adverse effects
Lumbar Vertebrae - surgery
Middle Aged
Multiple myeloma
Needles
Polyvinyl alcohol
Retention
Spinal Fractures - surgery
Spinal Fractures - therapy
Spine
Vertebroplasty - adverse effects
Vertebroplasty - methods
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A middle aged patient with multiple myeloma resulting in numerous pathological fractures underwent an L2, L3, and L5 vertebral cement augmentation for pain relief. After injection, the trocar at L2, the final level, could not be withdrawn despite several attempts of needle rotation, a second needle inserted to distract on, and rocking the needle on the pedicle. After a neurosurgical consultation, the patient was transferred to the operating room for open removal. As the needle protruded approximately 3 inches from the patient's back, the patient could not be positioned supine, and was anesthetized and intubated in the right semi-prone position prior to being placed prone on the operating room table. The needle was surgically exposed, cut off at the pedicular bone edge, and its free component was removed.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2015-012180