A Broken Drill-bit Fragment Causing Severe Radiating Pain after Cervical Total Disc Replacement: A Case Report

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Cervical total disc replacement (TDR) is a common procedure for degenerative disc disease.
• While generally safe, TDR can have rare complications.
• This report details an unprecedented complication following cervical TDR.

Purpose of the Study:

• To report a unique complication of cervical TDR involving a retained surgical instrument.
• To describe the diagnostic and management strategy for this complication.
• To emphasize safety considerations during TDR procedures.

Main Methods:

• A case report of a 38-year-old male patient who underwent cervical TDR at C5-6.
• Postoperative imaging revealed a retained metal fragment (suspected broken drill bit) in the spinal canal.
• Surgical intervention included anterior microforaminotomy for fragment removal, followed by anterior fusion.

Main Results:

• The patient experienced resolution of preoperative symptoms after TDR.
• One year postoperatively, sudden onset of severe radiating pain occurred.
• Surgical removal of the metal fragment and subsequent anterior fusion led to prompt symptomatic relief.

Conclusions:

• Retained surgical instruments, such as broken drill bits, are a potential risk during cervical TDR.
• Early diagnosis and surgical intervention are crucial for managing such complications.
• Meticulous surgical technique and attention to detail during drilling are essential to prevent instrument breakage.