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[Needle fracture during spinal puncture: case report.].

Marcos G C Cruvinel¹, André V C Andrade

¹Hospitais Vera Cruz.

Revista Brasileira De Anestesiologia

|May 28, 2009

Summary

Fine spinal needles, while reducing headaches, can fracture during difficult punctures due to increased resistance. This risk necessitates balancing benefits against potential needle fragility for patient safety.

Area of Science:

Anesthesiology
Neurosurgery
Medical Device Safety

Context:

Spinal anesthesia use is increasing due to fine gauge needles (26G, 27G, 29G) reducing post-dural puncture headaches.
Needle fracture during spinal puncture is an uncommon but significant complication.
This case highlights a needle fracture during a challenging spinal puncture for postoperative analgesia.

Purpose:

To report an unusual case of spinal needle fracture.
To identify potential causes of needle fracture during spinal anesthesia.
To suggest preventive measures for spinal needle fracture.

Summary:

A 53-year-old male undergoing emergency renal transplantation experienced a 27G spinal needle fracture during attempted L3-L4 and L2-L3 punctures.

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The 43 mm fragment was lodged in the interspinous ligament and removed surgically under fluoroscopic guidance.

The fracture occurred due to needle deformation from resistance encountered during multiple puncture attempts.

Impact:

Highlights the fragility of fine gauge spinal needles.
Emphasizes the need to consider material stress and resistance during spinal punctures.
Recommends balancing the advantages of fine needles against the risk of fracture in cases of difficult insertion.