Lomber Disk Herniasyonu Ameliyatı Sonrası Disk Mesafesinde Kalan Cerrahi Alet Parçasının Zamanla Semptomatik Hale Gelmesi
Özet
Bu vaka sunumu, daha önce lomber diskektomi geçiren bir hastada disk mesafesinde kalan metalik bir cerrahi alet parçasının uzun süre asemptomatik kaldığı nadir bir durumu ortaya koymaktadır. Alet parçası, zamanla minimal vücut hareketleri ile yer değiştirerek nöral yapılara baskı yapmış ve klinik semptomlara neden olmuştur. Parça mikrocerrahi yöntemle başarılı bir şekilde çıkarılmıştır. Bu vaka, cerrahi aletlerin düzenli bakımının, kontrolünün ve gerektiğinde yenilenmesinin önemini ortaya koymaktadır. Ayrıca, intraoperatif komplikasyonlar meydana geldiğinde hastaya bilgi verilmesi ve gerekli yasal kayıtların tutulması, medikolegal süreçlerin yönetimi açısından kritik öneme sahiptir.
This case report highlights the rare occurrence of a metallic surgical instrument fragment remaining in the disc space after a previous lumbar discectomy, which remained asymptomatic for an extended period. Over time, the intrument fragment migrated due to minimal body movements and eventually caused neural compression, leading to clinical symptoms. The fragment was successfully removed via microdiscectomy. This case underscores the importance of regular maintenance, inspection, and replacement of surgical instruments to prevent such complications. Additionally, it emphasizes the need for proper documentation and communication with the patient in the event of intraoperative complications, as these incidents can lead to significant medicolegal issues.
Referanslar
Mistry, J., White, L., Baraks, K. et al. Patient lived experiences of functioning and disability following lumbar discectomy: a secondary analysis of qualitative data. BMC Musculoskelet Disord 25, 731 (2024). https://doi.org/10.1186/s12891-024-07790-7
Harper, R., Klineberg, E. The evidence-based approach for surgical complications in the treatment of lumbar disc herniation. International Orthopaedics (SICOT) 43, 975–980 (2019). https://doi.org/10.1007/s00264-018-4255-6
Huseyin Dogu. Outcomes Comparison:Conservative and Surgical Treatments forEarly Recurrent Lumbar Disc Herniation.Ulutas Med J. 2024;10(4): 1-8DOI: 10.5455/umj.20240313083811
Sahinoglu M, Arun O, Orhan A, et al. Iliac Artery Injury During Lumbar Disc Hernia Surgery. World Neurosurg. 2019;125:347-351. doi:10.1016/j.wneu.2019.02.025
Lee M, Moriarity A, Mr Gerald M (2018) Fishing in the Dark: Retrieving Broken Instruments during a Spinal Lumbar Discectomy. Adv Tech Musculoskelet Surg 2(1):29-32.
Rahimizadeh A, Ghorbani E, Rahimizadeh S. Transforaminal retrieval of intradiscal retained broken surgical knife blade. Spine (Phila Pa 1976). 2013;38(20):E1278-E1281. doi:10.1097/BRS.0b013e31829ef4d7
Kale, S. , Tokmak, M. and Daimoglu, M. (2022) Should the Surgical Instrument Parts That Are Broken and Remain in the Distance of the Disc Be Removed? Should It Be Quit? A Case Report. Open Journal of Modern Neurosurgery, 12, 97-103. doi: 10.4236/ojmn.2022.122010.
Bostan, H., Kınoglu, K., Akın, H.M. and Caglar, S.A. (2016) Surgical Hand Tools Left at the Surgery Site. Türk Nöroşirürji Dergisi, 26, 174-176.
A. Kaimkuriya, B. Sethuraman, M. Gupta Effect of physical parameters on fatigue life of materials and alloys: a critical review, Technologies, 12 (2024), p. 100, 10.3390/technologies12070100
Amirjamshidi, A., Mehrazin, M. and Abbassion, K. (1994) Retained Broken Knife Blade within the Disc Space. Spine, 19, 981-984. https://doi.org/10.1097/00007632-199404150-00018
Azab MA, Hazem A. Retained Fractured Knife Blade: Unexpected Intraoperative Complication of Lumbar Discectomy: Report of an Event with a Technical Suggestion. Ann Med Case Rep. 2023;5(1):1041.
Punit Tiwari, Harmeet Kaur, Sandeep Singh Jaura, Arshad Ashraf,Retrieving the broken jaw of discectomy forceps from the intervertebral space turned out to be a Sisyphean task – A case report of an unprecedented complication of lumbar discectomy,Journal of Orthopaedic Reports, Volume 1, Issue 4,2022,https://doi.org/10.1016/j.jorep.2022.100085.
Zheng GB, Wang Z. Removal of the Deeply Located Intradiskal Broken Knife Blade with Arthroscopic Assistance: Case Report and Literature Review. World Neurosurg. 2020;137:272-275. doi:10.1016/j.wneu.2020.01.221
Referanslar
Mistry, J., White, L., Baraks, K. et al. Patient lived experiences of functioning and disability following lumbar discectomy: a secondary analysis of qualitative data. BMC Musculoskelet Disord 25, 731 (2024). https://doi.org/10.1186/s12891-024-07790-7
Harper, R., Klineberg, E. The evidence-based approach for surgical complications in the treatment of lumbar disc herniation. International Orthopaedics (SICOT) 43, 975–980 (2019). https://doi.org/10.1007/s00264-018-4255-6
Huseyin Dogu. Outcomes Comparison:Conservative and Surgical Treatments forEarly Recurrent Lumbar Disc Herniation.Ulutas Med J. 2024;10(4): 1-8DOI: 10.5455/umj.20240313083811
Sahinoglu M, Arun O, Orhan A, et al. Iliac Artery Injury During Lumbar Disc Hernia Surgery. World Neurosurg. 2019;125:347-351. doi:10.1016/j.wneu.2019.02.025
Lee M, Moriarity A, Mr Gerald M (2018) Fishing in the Dark: Retrieving Broken Instruments during a Spinal Lumbar Discectomy. Adv Tech Musculoskelet Surg 2(1):29-32.
Rahimizadeh A, Ghorbani E, Rahimizadeh S. Transforaminal retrieval of intradiscal retained broken surgical knife blade. Spine (Phila Pa 1976). 2013;38(20):E1278-E1281. doi:10.1097/BRS.0b013e31829ef4d7
Kale, S. , Tokmak, M. and Daimoglu, M. (2022) Should the Surgical Instrument Parts That Are Broken and Remain in the Distance of the Disc Be Removed? Should It Be Quit? A Case Report. Open Journal of Modern Neurosurgery, 12, 97-103. doi: 10.4236/ojmn.2022.122010.
Bostan, H., Kınoglu, K., Akın, H.M. and Caglar, S.A. (2016) Surgical Hand Tools Left at the Surgery Site. Türk Nöroşirürji Dergisi, 26, 174-176.
A. Kaimkuriya, B. Sethuraman, M. Gupta Effect of physical parameters on fatigue life of materials and alloys: a critical review, Technologies, 12 (2024), p. 100, 10.3390/technologies12070100
Amirjamshidi, A., Mehrazin, M. and Abbassion, K. (1994) Retained Broken Knife Blade within the Disc Space. Spine, 19, 981-984. https://doi.org/10.1097/00007632-199404150-00018
Azab MA, Hazem A. Retained Fractured Knife Blade: Unexpected Intraoperative Complication of Lumbar Discectomy: Report of an Event with a Technical Suggestion. Ann Med Case Rep. 2023;5(1):1041.
Punit Tiwari, Harmeet Kaur, Sandeep Singh Jaura, Arshad Ashraf,Retrieving the broken jaw of discectomy forceps from the intervertebral space turned out to be a Sisyphean task – A case report of an unprecedented complication of lumbar discectomy,Journal of Orthopaedic Reports, Volume 1, Issue 4,2022,https://doi.org/10.1016/j.jorep.2022.100085.
Zheng GB, Wang Z. Removal of the Deeply Located Intradiskal Broken Knife Blade with Arthroscopic Assistance: Case Report and Literature Review. World Neurosurg. 2020;137:272-275. doi:10.1016/j.wneu.2020.01.221
