title: Retained needle after cement injection during vertebral augmentation and its management strategy.
abstract: A middle aged patient with multiple myeloma resulting in numerous pathological fractures underwent an L2, L3, and L5 vertebral cement augmentation for pain relief. After injection, the trocar at L2, the final level, could not be withdrawn despite several attempts of needle rotation, a second needle inserted to distract on, and rocking the needle on the pedicle. After a neurosurgical consultation, the patient was transferred to the operating room for open removal. As the needle protruded approximately 3 inches from the patient's back, the patient could not be positioned supine, and was anesthetized and intubated in the right semi-prone position prior to being placed prone on the operating room table. The needle was surgically exposed, cut off at the pedicular bone edge, and its free component was removed.
authors.affiliation: Department of Anesthesiology, Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Angelika
authors.initials: A
authors.lastname: Kosse
authors.affiliation: Department of Neurological Surgery, Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Jonathan Pishoi
authors.initials: JP
authors.lastname: Nakhla
authors.affiliation: Department of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Reza
authors.initials: R
authors.lastname: Yassari
authors.affiliation: Bronx, USA.
authors.forename: Apolonia Elisabeth
authors.initials: AE
authors.lastname: Abramowicz
authors.affiliation: Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Allan
authors.initials: A
authors.lastname: Brook
keywords: Complication; Degenerative; Intervention; Lumbosacral; Technique