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

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Pain Management

Background:

• Multiple myeloma can cause pathological fractures, necessitating interventions like vertebral augmentation.
• Vertebral cement augmentation is a common procedure for pain relief in patients with spinal fractures.

Purpose of the Study:

• To report a rare complication during vertebral cement augmentation.
• To describe the management of a retained trocar during a minimally invasive spinal procedure.

Main Methods:

• A patient with multiple myeloma underwent L2, L3, and L5 vertebral cement augmentation.
• A trocar at the L2 level became impacted and could not be removed using standard techniques.
• Neurosurgical consultation led to open surgical removal of the impacted trocar.

Main Results:

• The L2 trocar could not be withdrawn after vertebral cement augmentation.
• The impacted trocar required surgical intervention for removal.
• The patient underwent open surgery for trocar extraction, with the needle cut at the bone edge.

Conclusions:

• Impa cted trocars during vertebral augmentation present a significant challenge.
• Prompt neurosurgical consultation and surgical intervention are crucial for managing retained instruments.
• Careful surgical technique is essential to minimize complications during minimally invasive spinal procedures.