脊椎および脳神経外科ジャーナル

Intradiscal Retained Broken Blade Of A Disc Rongeur

Abolfazl Rahimizadeh

Lumbar discectomy is done in increasing frequency worldwide. A rare event associated with this procedure is breaking of the disc forceps blade during discectomy. In majority the broken part of the disc forceps can be removed during the initial surgery. But, rarely, the surgeon’s attempts might be unsuccessful, resulting in intradiscal retained foreign body. Literature regarding this issueis scarce, although there might be cases that have been never reported because of the medico legal consequences. Furthermore, until recently, there have been no guidelines to address this complication. Herein, a middle age woman in whom the blade of disc forceps was broken during L5-S1 discectomy is presented. Her surgeon could not remove the broken blade, so it was retained. .Once the patient and her family became aware about this event, began to seek medical advice .In our institute, retrieval of the broken blade of the disc forceps became possible via transforaminal corridor. Thereafter, posterior screw rod fixation and L5-S1 interbody fusion was done.
To our knowledge, the reports about the broken surgical instruments being retained in the disc space are extremely rare complication of lumbar discectomy. Moreover, xtraforaminal or transforaminal corridor might an appropriate alternative option instead of anterior or anterolateral approaches.