Retrieval of fractured bone marrow Biopsy needle from S1 vertebra and corresponding sacroiliac joint: A case report

Abstract

Introduction: Bone marrow biopsy (BMB) is a routinely done procedure with minimum risks and complications. Although an infrequent event, needle breakage during biopsy can occur even without technical errors. We report a case of broken BMB needle that occurred during one such procedure and the technique by which we retrieved it out. Case report: A 22-year-old female with pancytopenia admitted in our tertiary care hospital was planned for BMB from posterior iliac crest for definitive diagnosis and further detailed evaluation. However, during the procedure the BMB needle broke with the distal portion remaining embedded in the left sacrum. Subsequently Orthopaedic Department was consulted for retrieval of the broken needle. CT scan was performed for better appreciation of needle position in the bone and the embedded needle was removed in the theatre under fluoroscopy. There were no post-operative complications and patient had an uneventful 14 months follow up. Conclusion: Breakage of biopsy needle, although rare, have been reported in few instances and awareness about the possibility of such troublesome event is a requisite to avoid them. Usage of good quality needles, adequate anaesthesia or sedation when needed, and supervision by experienced personnel when technical difficulty is anticipated can help in preventing such complications.

Keywords

• Fractured biopsy needle
• Bone marrow
• Sacrum
• Sacroiliac joint