Unexpected retention of a spinal needle in a morbidly obese patient: a case report and technical reflection
Bibliographic record
Abstract
Spinal anesthesia is considered a safe and effective anesthetic technique. However, some complications may be encountered in clinical settings such as needle fracture or retention, which is a rare but serious complication. Morbid obesity is a recognized risk factor for such technical difficulties due to increased tissue depth and altered anatomical landmarks. A 19-year-old male (BMI > 40) presented for elective umbilical hernia repair. Spinal anesthesia was attempted using a 25 G Vygon needle (120 mm). During the successful puncture, the patient suddenly hyperextended his back. On attempted needle withdrawal and redirection, only the introducer was retrieved; the spinal needle was retained subcutaneously. Surgical removal via a 10 mm incision at 6 cm depth was successful. Multiple factors contributed: morbid obesity, sudden patient movement, weak contact between introducer and needle, and potentially defective equipment. This case underscores the need for vigilance, appropriate equipment, and immediate multidisciplinary management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.005 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.009 | 0.006 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".