Barbero-Aznarez Pablo, Bucheli-Peñafiel Carlos, Olmos-Francisco Eduardo, Lorente-Muñoz Asís, Cortés-Franco Severiano
Department of Neurosurgery, Hospital Quironsalud Zaragoza, Zaragoza, Aragon, Spain.
Surg Neurol Int. 2021 Jan 20;12:25. doi: 10.25259/SNI_880_2020. eCollection 2021.
There are rare reports of broken surgical blades occurring during lumbar discectomy, and even fewer that discuss their retrieval.
While a 54-year-old male was undergoing a lumbar discectomy, the knife blade was broken. As it was difficult to retrieve the fragment through the original incision, the patient was closed, and a postoperative angio-computerized tomography (CT) was obtained. When the CT angiogram (CTA) documented the retained fragment had become lodged near the iliac vein within the psoas muscle, a second operation for blade retrieval, consisting of a paravertebral, lateral transpsoas approach, was successfully performed.
In some cases, it is difficult to retrieve a broken scalpel blade during the index surgery. When this occurs, we would recommend closing the patient, and obtaining a CTA to better document the location of the retained foreign body. Based upon these findings, a safer second stage procedure may be performed (e.g., as in this case using a paravertebral lateral transpsoas approach) to avoid undue sequelae/morbidity.
关于腰椎间盘切除术中手术刀片断裂的报道罕见，而讨论其取出的报道则更少。
一名54岁男性在接受腰椎间盘切除术时，刀片断裂。由于难以通过原切口取出碎片，遂关闭切口，术后行血管计算机断层扫描（CT）。当CT血管造影（CTA）显示残留碎片位于腰大肌内髂静脉附近时，成功实施了第二次手术取出刀片，采用经椎旁、外侧经腰大肌入路。
在某些情况下，一期手术中取出断裂的手术刀刀片可能困难。发生这种情况时，我们建议关闭患者切口，行CTA以更好地记录残留异物的位置。基于这些发现，可实施更安全的二期手术（如本例采用经椎旁外侧经腰大肌入路）以避免不必要的后遗症/并发症。
