Removal of a migrated acupuncture needle from the cervical spinal canal with removal confirmation by cone-beam computed tomography in a hybrid operating room

Ichiro Kawamura; Hiroyuki Tominaga; Hiroto Tokumoto; Daisuke Sakuma; Masato Sanada; Takuma Ogura; Noboru Taniguchi

doi:10.1016/j.tcr.2023.100772

Removal of a migrated acupuncture needle from the cervical spinal canal with removal confirmation by cone-beam computed tomography in a hybrid operating room

Trauma Case Rep. 2023 Jan 10:43:100772. doi: 10.1016/j.tcr.2023.100772. eCollection 2023 Feb.

Authors

Ichiro Kawamura¹, Hiroyuki Tominaga¹, Hiroto Tokumoto¹, Daisuke Sakuma¹, Masato Sanada¹, Takuma Ogura¹, Noboru Taniguchi¹

Affiliation

¹ Department of Orthopaedic Surgery, Graduate School of Medicine and Dental Science, Kagoshima University, Kagoshima, Japan.

Abstract

Background: Acupuncture has become one of the most popular alternative medical treatments in the world. However, if the needle is inserted incorrectly into the body, various adverse events can occur and, in such cases, the needle should be removed. Acupuncture needles are very thin and fragile, making them difficult to detect and to confirm breakage or residual needle fragments during surgery. We report a case of a patient's self-placed acupuncture needle migrating into the cervical spinal canal and its surgical removal. We used cone-beam computed tomography in the hybrid operating room to confirm that the needle was removed in its entirety.

Case presentation: A 37-year-old man presented with neck pain and gait disturbance.While he was self-acupuncturing, an acupuncture needle accidentally broke, and the remaining part of the needle penetrated and made contact with the cervical spinal cord. Cervical spine radiographs showed a metallic foreign body between the C1 and C2 spinous processes in the direction of the anterior cervical spine. Computed tomography images revealed that the acupuncture needle was penetrating the spinal canal and was in contact with the cervical cord. The acupuncture needle was removed under general anesthesia. The use of cone-beam computed tomography in the hybrid operating room allowed intraoperative confirmation that there was no breakage during needle removal, and no needle fragments were left behind. His symptoms disappeared without any complications after the operation.

Conclusion: To the best of our knowledge, this is the first report of the removal of an acupuncture needle that migrated into the cervical spinal canal using cone-beam computed tomography in a hybrid operating room. Intraoperative cone-beam computed tomography is useful in patients with small, fragile foreign bodies for confirmation of the location of the object and to check for the presence of residual fragments.

Keywords: Acupuncture; Cervical cord; Cone-beam computed tomography; Foreign body; Hybrid operating room; Spinal canal.

Publication types

Case Reports