Spinal needle fracture during attempted spinal anaesthesia for caesarean delivery: a series of three cases

Spinal needle fracture during spinal anaesthesia is a rare but potentially serious complication, particularly in obstetric practice where neuraxial techniques are frequently used. We report a series of three cases of spinal needle fracture during attempted spinal anaesthesia for caesarean delivery and describe a common technical mechanism and management approach.

Three patients with obesity had an attempted spinal anaesthetic for caesarean delivery with a fine-gauge pencil-point spinal needle through an introducer. In all cases, fracture occurred during needle redirection while the introducer remained stationary. The neuraxial attempt was abandoned and caesarean delivery proceeded under general anaesthesia in all three cases. Postpartum imaging with computed tomography was used to localise the retained fragments, which were subsequently removed surgically. Neurologic assessment during admission and follow-up at two weeks and one month demonstrated no neurologic deficits in any patient.

Spinal needle fracture can occur when redirection of a fine spinal needle is attempted through a fixed introducer. Awareness of this mechanism, careful technique, and early imaging are essential to reduce risk and guide management in this rare complication.