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Successful retrieval of a broken pituitary rongeur tip from the lumbar intervertebral disc space using a magnetic
Luis Alberto Navarro-Aceves1, Luis Alberto Navarro-Orozco1, Luis Miguel Rosales-Olivarez2
1Department of Orthopedic Surgery and Spine Surgery, Puerta de Hierro Andares Hospital, Zapopan, Jalisco, Mexico.
Background:
Unexpected events such as instrument breakage during a routine lumbar microdiscectomy can pose a risk for nerve root injury, durotomy, infection, and anterior displacement into the retroperitoneal space. Removal of broken instruments requires planning, patience, and sometimes subsequent surgical procedures. Here, the authors explore the effectiveness of a magnetic probe for the retrieval of broken metallic (magnetic) pieces.
Observations:
A 47-year-old man with right leg radiculopathy due to a right L5-S1 disc extrusion had undergone a lumbar microdiscectomy that was complicated by the pituitary rongeur tip breaking in the L5-S1 disc space. The rongeur tip was successfully retrieved by widening the entry access without damaging the adjoining facet and utilizing a blunt nerve hook, a probe dissector, forceps tips, curette heads, and a magnetic probe.
Lessons:
The use of a magnetic probe provides a safe and effective method for retrieving metallic fragments during lumbar disc surgery. This case highlights the importance of considering alternative techniques such as magnetic retrieval in the management of intraoperative instrument breakage. https://thejns.org/doi/10.3171/CASE24377.
