Percutaneous retrieval of an intrathecal foreign body: technical note

Abstract

A 58-year-old man had an intrathecal baclofen pump implanted. A guidewire used during removal of a previously placed lumbar drain catheter fractured, and a fragment was left within the thecal sac. Using fluoroscopic guidance, a loop snare device was used to retrieve the intrathecal foreign body successfully and without complication. The pump was placed without any difficulty, and the patient's hospital course was uneventful.

Minimally invasive repair of a pseudomeningocele caused by a sheared intrathecal catheter following implantation of a drug delivery system

“…[ 21 26 ] Retraction of the catheter in the Tuohy needle, the use of a guidewire when confronted with a difficult placement and excessive traction during removal of the catheter has been proposed as risk factors for shearing during the implantation procedure. [ 10 15 21 ] The incidence of retained fragments has been reported in 1.8–3.3% of patients who underwent CSF diversion with lumbar drain. [ 4 21 26 ]…”

Intrathecal Therapeutics: Device Design, Access Methods, and Complication Mitigation

“…As noted in the examples shown in Table and represented schematically in Fig. , the spectrum of catheter‐related complications reported in the literature include obstructions , positional displacements , catheter coiling and engagement of the dorsal nerve rootlets , guidewire fracture , disconnection with the pump or pump‐related failure , infections , intrathecal granulomas and inflammatory masses , bradycardias due to catheter contact with the spinal cord , arachnoiditis , syrinx formation , and Harlequin syndrome . The physician most often will be faced with questions concerning surgical site infection or medication under‐dose or overdose.…”

“…When the entirety of the catheter fragment is intrathecal, removal is generally more invasive involving laminar removal and durotomy. However, there are reports of endovascular tools being repurposed to ensnare foreign material in the intrathecal space .…”