利用磁探头成功地从腰椎间盘间隙取出断裂的垂体咬头:说明性病例。

Luis Alberto Navarro-Aceves, Luis Alberto Navarro-Orozco, Luis Miguel Rosales-Olivarez, Carla L Garcia Ramos, Irving O Estevez, Barón Zárate-Kalfópulos
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引用次数: 0

摘要

背景:常规腰椎微椎间盘切除术中器械断裂等意外事件可能导致神经根损伤、硬膜切开术、感染和前移位至腹膜后间隙。切除破损的器械需要计划、耐心,有时还需要后续的外科手术。在这里,作者探讨了磁性探针的有效性为检索破碎的金属(磁性)片。观察:一名47岁男性患者因右侧L5-S1椎间盘突出导致右腿神经根病,行腰椎微椎间盘切除术,并发L5-S1椎间盘间隙垂体咬头断裂。利用钝神经钩、探针解剖器、钳头、刮刀头和磁探头,在不损伤相邻关节突的情况下扩大入路,成功取出了咬头。经验:在腰椎间盘手术中,磁探头是一种安全有效的金属碎片回收方法。这个病例强调了在处理术中器械断裂时考虑其他技术的重要性,如磁回收。https://thejns.org/doi/10.3171/CASE24377。
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Successful retrieval of a broken pituitary rongeur tip from the lumbar intervertebral disc space using a magnetic probe: illustrative case.

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.

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