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  4. Surgical tool entrapment in a young patient with recurrent lumbar spinal stenosis: a case report

Surgical tool entrapment in a young patient with recurrent lumbar spinal stenosis: a case report

Clin Case Rep, 2023 · DOI: 10.1002/ccr3.8220 · Published: November 4, 2023

SurgerySpinal DisordersResearch Methodology & Design

Simple Explanation

Lumbar spinal stenosis (LSS) is a condition causing leg and back pain, especially in older adults. This case report discusses a rare instance of a surgical tool being left inside a young patient's spine during a surgery to treat LSS. The patient initially had back pain relieved by spinal fusion surgery. However, the pain returned and worsened over time. Further imaging revealed a retained surgical instrument, which required additional surgeries to remove. This case highlights the importance of being aware of potential complications like surgical tool entrapment and the need for careful follow-up to identify and address any resulting neurological issues promptly.

Study Duration
Not specified
Participants
One 24-year-old male
Evidence Level
Level 4: Case Report

Key Findings

  • 1
    Surgical tool entrapment can occur during spinal fusion procedures, even though it is rare.
  • 2
    Retained surgical objects can cause worsening neurological symptoms, such as back pain and urinary problems, that may appear either soon after the initial surgery or develop later.
  • 3
    Removal of the entrapped object can resolve the patient's symptoms, but multiple surgeries might be required to locate and extract the foreign body.

Research Summary

This case report describes a 24-year-old male with lumbar spinal stenosis (LSS) who experienced recurrent pain after spinal fusion due to a retained surgical curette edge. The patient underwent multiple surgeries before the foreign object was identified and removed, leading to symptom resolution. The case underscores the importance of considering retained surgical objects in patients with recurrent pain after spinal surgery. The authors highlight the potential for neurological sequelae and the need for careful follow-up and appropriate imaging techniques when managing patients post-spinal surgery.

Practical Implications

Surgical awareness

Surgeons should be vigilant about the possibility of instrument breakage and entrapment during spinal surgeries.

Post-operative monitoring

Patients undergoing spinal fusion should be monitored for recurrent or worsening pain, prompting investigation for potential complications like retained surgical objects.

Imaging and diagnosis

Appropriate imaging techniques, such as CT scans, are essential for identifying retained surgical instruments and guiding further interventions.

Study Limitations

  • 1
    Limited follow-up on the tool's migration.
  • 2
    Limited information on the patient's situation during the first operation.
  • 3
    Poor generalizability of the findings due to the nature of a case report.

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