Successful retrieval of a retained Jamshidi needle fragment from the L4 pedicle following elective basivertebral nerve ablation: illustrative case.

backgroundSpinal needle breakage is a rare complication of spinal anesthesia procedures, most commonly reported in cases of neuraxial anesthesia administered for inpatient surgeries. To date, there has been no report of spinal needle breakage during an outpatient spine pain management procedure. OBSERVATIONS: Here, the authors present the case of a 63-year-old man who presented to the emergency department with a broken Jamshidi cannula protruding from his lumbar spine following a basivertebral nerve ablation (BVNA) performed at an outside facility. Neurosurgery was consulted for emergency resection of the retained instrument, which was lodged in the left L4 pedicle. Intraoperative and postoperative imaging confirmed complete extraction of the fragment, and the patient was discharged the following day without further complications. LESSONS: Spinal needle breakage is an exceedingly rare complication of spinal anesthesia and has not previously been reported in the context of outpatient spine pain management procedures like BVNAs. In such cases, prompt neurosurgical evaluation and resection are essential to prevent neurological injury, infection, or other adverse outcomes. https://thejns.org/doi/10.3171/CASE25723.