Postoperative Radiculopathy Caused by a Retained Fractured Pedicle Cannulation Probe and Its Mechanism of Extraction

Frank Yuk, Jeremy Steinberger, Branko Skovrlj, Justin Mascitelli, Samuel K. Cho, John M. Caridi

Research output: Contribution to journalArticlepeer-review

Abstract

Background Spine surgery relies heavily on technology and surgical instrumentation. Improperly used instrumentation can be detrimental to the patient. Despite multiple checkpoints to ensure that foreign bodies are not retained in surgery, numerous case reports have described retained foreign bodies; however, none of these cases involve retained instrumentation after open spine surgery. Of the retained objects, 4 were sponges and one was a Jamshidi needle fragment. Although smaller objects are more commonly the culprits, surgical instruments can break off, remain stuck, and cause clinical sequelae. Case Description This case presents a retained fractured pedicle finder as the cause of right L5 radiculopathy. To our knowledge, this report is the first to describe an instrumentation-associated postoperative radiculopathy. Because of the strength with which the object was impacted, its extraction proved difficult. Conclusions The technique of removal using a mallet and osteotome in 4 directions to loosen its hold in the vertebral body. Attempts and eventual successful removal are described.

Original languageEnglish (US)
Pages (from-to)1044.e1-1044.e4
JournalWorld neurosurgery
Volume107
DOIs
StatePublished - Nov 2017
Externally publishedYes

Keywords

  • Foreign object
  • Lumbar spine
  • Lumbar surgery
  • Pedicle finder
  • Pedicle probe
  • Radiculopathy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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