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

Abstract

Background: Sparse literature on the topic and unheard surgical ordeal have prompted us to share our experience of retrieving the broken jaw of discectomy forceps lost in the intervertebral space. To the best of our knowledge, this is the first case report on the topic from the Indian subcontinent. Case report: A 53-year-old Indian man underwent standard laminotomy and discectomy. Towards the end of the surgery, the jaw of the ill-fated discectomy forceps broke inside the L4 – L5 intervertebral disc space while taking out the disc material. All efforts to retrieve the broken piece of discectomy forceps failed. First, a hemilaminectomy and then a complete laminectomy was performed and after a lot of struggle, the broken jaw of discectomy forceps could be retrieved with a cholecystectomy grasper, keeping the facet joints and the pars intact. Conclusion: The surgeon should be well aware of this possible complication, how to manage it and when to give up the search considering the pros and cons of retaining the broken piece inside the disc space. It should be part of the consent dialogue with the patient. Ever-rising medicolegal implications make the documentation of this unforeseen complication in medical literature even more important.

Keywords

• Discectomy
• Forceps
• Intraoperative complication
• Instrument breakage
• Spine surgery
• Intervertebral disc