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Anterior pushing technique for a broken scalpel blade in lumbar discectomy: a case report – Lumbar Spinal Stenosis

The article discusses a rare but serious complication that can occur during posterior lumbar spine procedures, which is the presence of broken surgical blades or other sharp objects in the disc space. The case of a 59-year-old female patient who underwent an instrumented revision of the lumbosacral junction is reported. During the procedure, the scalpel blade broke and could not be retrieved through the posterior approach. The authors used an anterior pushing technique with fluoroscopy to partially push the broken fragment into the retroperitoneal space, and pedicle screws were locked for stability. The broken fragment was eventually removed through laparoscopy one week later. The article suggests that this anterior pushing technique can be considered in rare cases where a broken scalpel blade cannot be reached through the posterior approach and recommends the use of computed tomography angiography

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spine clinic in London

Published article

The presence of broken surgical blades or other surgically uncontrolled sharp and pointed objects in the disc space is a rare but potentially severe complication of posterior lumbar spine procedures. Herein, we report the case of a 59-year-old female patient with a history of lumbar decompression and interspinous process device implantation who underwent an instrumented revision of the lumbosacral junction. During the L5-S1 discectomy, the scalpel blade broke, and the broken fragment could not…

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Front Surg. 2023 Sep 27;10:1266102. doi: 10.3389/fsurg.2023.1266102. eCollection 2023.ABSTRACTThe presence of broken surgical blades or other surgically uncontrolled sharp and pointed objects in the disc space is a rare but potentially severe complication of posterior lumbar spine procedures. Herein, we report the case of a 59-year-old female patient with a history of lumbar decompression and,

Front Surg. 2023 Sep 27;10:1266102. doi: 10.3389/fsurg.2023.1266102. eCollection 2023.

ABSTRACT

The presence of broken surgical blades or other surgically uncontrolled sharp and pointed objects in the disc space is a rare but potentially severe complication of posterior lumbar spine procedures. Herein, we report the case of a 59-year-old female patient with a history of lumbar decompression and interspinous process device implantation who underwent an instrumented revision of the lumbosacral junction. During the L5-S1 discectomy, the scalpel blade broke, and the broken fragment could not be retrieved through the posterior approach. With regard to the vascular anatomy, we partially pushed the fragment through the anterior annulus into the retroperitoneal space. In addition, pedicle screws were locked to ensure the stability of the construct. The fractured blade fragment was eventually removed by laparoscopy 1 week after the initial procedure. This experience suggests that the anterior pushing technique with fluoroscopy is an option in rare cases where a broken scalpel blade cannot be reached through the posterior approach. In such cases, computed tomography angiography is recommended.

PMID:37829599 | PMC:PMC10564983 | DOI:10.3389/fsurg.2023.1266102

The London Spine Unit : innovative spine clinic in London

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Anterior pushing technique for a broken scalpel blade in lumbar discectomy: a case report

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Front Surg. 2023 Sep 27;10:1266102. doi: 10.3389/fsurg.2023.1266102. eCollection 2023.ABSTRACTThe presence of broken surgical blades or other surgically uncontrolled sharp and pointed objects in the disc space is a rare but potentially severe complication of posterior lumbar spine procedures. Herein, we report the case of a 59-year-old female patient with a history of lumbar decompression and

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