ILYASS MASAD, NAJOUT HAMZA, MOUTAOUAKIL MOHAMED, MUSTAPHA BENSGHIR
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 10
Date of Publication: 2026/10/04
Background: Fracture and retention of a spinal needle are uncommon complications of neuraxial anesthesia. Published obstetric cases generally describe recognition during the procedure or presentation in the early postoperative period. Delayed focal lumbar symptoms accompanied by a skin lesion warrant consideration of a retained foreign body.
Case presentation: A 27-year-old woman with no known medical history presented with low back pain and a localized lumbar abscess approximately two years after cesarean delivery under spinal anesthesia. A metallic needle fragment protruded through a small cutaneous lesion. Lumbar computed tomography demonstrated a linear metallic foreign body in the posterior soft tissues. Neurological examination was normal. The fragment was removed under local anesthesia. Purulent material yielded Staphylococcus aureus susceptible to amoxicillin–clavulanate. The subsequent clinical course was favorable.
Discussion: This presentation illustrates the diagnostic relevance of a remote neuraxial procedure in a patient with focal lumbar inflammation. The association of delayed recognition, cutaneous protrusion and microbiologically documented infection distinguishes this observation from early presentations described in the literature. Anatomical localization, neurological assessment and microbiological sampling help characterize the complication and guide management.
Conclusion: A retained needle fragment should be considered when focal lumbar pain and a persistent inflammatory skin lesion occur after neuraxial anesthesia, even after a prolonged interval. Anatomical localization and documented treatment and follow-up are essential components of the case assessment.
spinal anesthesia; retained needle; foreign body; lumbar abscess; cesarean delivery; delayed presentation.
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