Related Experiment Video
Updated: Nov 17, 2025
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
Broken surgical blade retrieval following lumbar discectomy through paravertebral/lateral transpsoas approach: A case
Pablo Barbero-Aznarez1, Carlos Bucheli-Peñafiel1, Eduardo Olmos-Francisco1
1Department of Neurosurgery, Hospital Quironsalud Zaragoza, Zaragoza, Aragon, Spain.
Background:
There are rare reports of broken surgical blades occurring during lumbar discectomy, and even fewer that discuss their retrieval.
Case Description:
While a 54-year-old male was undergoing a lumbar discectomy, the knife blade was broken. As it was difficult to retrieve the fragment through the original incision, the patient was closed, and a postoperative angio-computerized tomography (CT) was obtained. When the CT angiogram (CTA) documented the retained fragment had become lodged near the iliac vein within the psoas muscle, a second operation for blade retrieval, consisting of a paravertebral, lateral transpsoas approach, was successfully performed.
Conclusion:
In some cases, it is difficult to retrieve a broken scalpel blade during the index surgery. When this occurs, we would recommend closing the patient, and obtaining a CTA to better document the location of the retained foreign body. Based upon these findings, a safer second stage procedure may be performed (e.g., as in this case using a paravertebral lateral transpsoas approach) to avoid undue sequelae/morbidity.
Insights
Broken surgical blades during lumbar discectomy are rare. A CT angiogram (CTA) guided a second surgery for safe retrieval of a retained fragment near the iliac vein.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Surgical Complications
Background:
- Broken surgical blades during lumbar discectomy are infrequent occurrences.
- Limited literature exists on the retrieval of such retained foreign bodies.
Observation:
- A 54-year-old male patient experienced a broken knife blade during a lumbar discectomy.
- The fragment was difficult to retrieve via the initial incision, necessitating closure and further imaging.
Findings:
- Postoperative angio-computerized tomography (CT) revealed the retained fragment lodged in the psoas muscle near the iliac vein.
- A subsequent surgery utilizing a paravertebral, lateral transpsoas approach successfully retrieved the blade fragment.
Implications:
- Difficulties in retrieving broken surgical blades during index procedures necessitate alternative strategies.
- Recommending patient closure and obtaining CT angiography (CTA) can precisely locate retained fragments.
- A staged surgical approach, guided by imaging, can ensure safer retrieval and minimize patient morbidity.
