Anesthesiology/spinal needle


QUESTION: Dr Russell,my original disc operation was at level L5 and as written in operation sheet by surgeon that spinal needle marker was used to identify disc level at L5 .But spinal needle that was found on x ray and MRI at s2 level. So does this mean that spinal needle marker used to identify disc level was inserted at wrong level in S2  where it was removed? You have all  information from previous questions,it seems clear that,s what happened.Please reply Thank You

ANSWER: There are several reasons why that need on might have been at the S2 level. they could have attempted at the S to level on the initial trial to see where they were at and that's when the needle could've been placed there. Or, the needle could have migrated there from any other level through time. Space it is common when starting or prior to incision to place a needle on the back and take a picture. After an x-ray has been taken the needle will be moved or modified based on the location and further x-rays will be taken until they have located below the level that they want to be at.

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QUESTION: DR Russell thanks for your reply.The needle did not migrated because it was in same place S2 on first MRI as it was in last MRI and x ray 7 months later when fragment of needle was removed.So as you say they attempted initial trail at s2 level so this has to  be the spinal needle marker fragment left in my spine seen on x ray and MRI?.  What does the term [needle fragment] mean in your terms? Thank you Dr Russell  please reply.

To me that means a part Ava a needle. To me it suggests that somehow the needle broke off and was retained. I find it hard to believe that a needle was broken to the point where it detached from the rest of the needle by simply placing it in your body.obviously, there was something retained but by simply knowing that it is there it is almost impossible to know the mechanism by which he came to rest there. However as soon as a needle was recognized on an image, it should have been easily removed if it was causing problems. by the way, finding a needle fragment at the S2 level does not mean that the insertion occurred at that level. Didn't spinal needles used to locate a level with X-ray during the case are flexible and can bend and then travel up or down the body several segments.


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Rex Russell


Any question dealing with general anesthesia issues. With particular emphasis on regional anesthesia.


I am a board certified anesthesiologist, graduated from residency in 2004 from Johns Hopkins Hospital. I have since worked as an anesthesiologist first in the Air Force for three years and then most recently in Texas in Private Practice.

Texas Medical Association Texas society of Anesthesiologists American Society of Anesthesiologists

BS, BYU MD, U of Texas, Galveston Intern-St. Joe's Hospital, Phx, AZ Internal Medicine Residency-Johns Hopkins Hospital, Baltimore, MD

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