Biportal endoscopic spinal surgery for removal of retained epidural catheter fragment: A case report

Epidural catheter fracture is a rare but clinically significant complication of epidural anesthesia. Retained fragments may cause adhesions, fibrosis, granuloma, infection, or neurological symptoms. We report a 31-year-old woman who underwent cesarean delivery under epidural anesthesia. The catheter fractured during withdrawal through the Tuohy needle at L2–L3, leaving a 7 cm fragment in the right posterolateral epidural space, confirmed by computed tomography. Considering the patient’s young age and risk of delayed complications, biportal endoscopic spinal surgery (BESS) was performed on post-operative day 2 following cesarean delivery. The fragment was directly visualized and completely removed. This case suggests that early BESS intervention enables safe, minimally invasive removal while preventing the need for more complex delayed surgery.