title: Endoscopic Retrieval of a Broken Guidewire During Spinal Surgery.
abstract: Since the percutaneous posterolateral approach in treating lumbar disc herniation was introduced in 1973, percutaneous endoscopic lumbar discectomy (PELD) has become a routine minimally invasive spinal procedure. However, as clinical evidence accumulated, several complications of PELD have raised our concerns, including the intraoperative injury to neural, vascular structures and failure of surgery. Herein, we present 2 patients who experienced guidewire breakage during PELD procedure to demonstrate the details.The 2 patients, who are 28 and 33 years old, were diagnosed with lumbar disc herniation with or without intervertebral foreman stenosis by magnetic resonance imaging. Following a preoperative evaluation, a PELD procedure was performed with the help of local anesthesia. During the advancement of the obturator and foraminotomy under fluoroscopy, the guidewire was found broken. With the patients permission, the operator inserted the working cannula to the broken end of the guidewire and retrieved it by straight grasping forceps under endoscopy. The patients were reported to recover from their back pain immediately after the operation and hence the postoperative course was stable.In conclusion, the guidewire breakage in PELD procedures is a rare but severe complication, which requires immediate removal. An appropriate manner and fluoroscopic control are recommended to forestall such problems. It is.
authors.affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, People's Republic of China.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Guan
authors.affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, People's Republic of China.
authors.forename: Xinbo
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, People's Republic of China.
authors.forename: Guoxin
authors.initials: G
authors.lastname: Fan
authors.affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, People's Republic of China.
authors.forename: Shan
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, People's Republic of China.
authors.forename: Guangfei
authors.initials: G
authors.lastname: Gu
authors.affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, People's Republic of China.
authors.forename: Hailong
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Gu
authors.affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, People's Republic of China.
authors.forename: Shisheng
authors.initials: S
authors.lastname: He
mesh_terms: D000328:Adult; D020878:Device Removal / Q000379:methods; D017587:Diskectomy, Percutaneous / Q000009:adverse effects*; D004724:Endoscopy / Q000379:methods*; D004868:Equipment Failure; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome