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February 26, 1973

Retained Surgical Sponge Following Laminectomy

Author Affiliations

Naval Hospital Charleston, SC

JAMA. 1973;223(9):1040. doi:10.1001/jama.1973.03220090060018

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To the Editor.—  We wish to report a case of retained surgical sponge following lumbar laminectomy.The patient underwent bilateral, partial hemilaminectomy with excision of an L5-S1 herniated nucleus pulposus that had been demonstrated myelographically on the right. Exploration of the left S-1 root through the left partial hemilaminectomy was hampered by significant bleeding that was controlled with neurosurgical cottonoids (small surgical sponges on strings). Before closing the incision, the wound was carefully inspected for hemostasis and sponges.Postoperatively, the patient complained of episodic hypalgesia over the lateral aspect of both thighs. During the next month, persistence of the hypalgesia was accompanied by back and bilateral radicular pain. Repeat myelogram demonstrated a posterior extradural defect at the level of the L4-5 disc. Contained within this mass was a radiopaque sponge marker (Figure).At the second operation, exploration of the L4-5 level, which was one level higher than at the initial