Endoscopic percutaneous extraction of a retained bullet fragment in the lumbar spine for lead toxicity management: illustrative case

Endoscopic techniques present a promising approach for removing bullets from the spine, with reduced tissue trauma, improved visualization, and shorter recovery times compared with traditional open or minimally invasive surgery. In cases of retained bullet fragments with no focal deficit, migration, or instability, conservative management with serial lead monitoring is recommended. However, when surgical removal is indicated from lead toxicity, endoscopic extraction of foreign bullets can be considered as an effective, yet less invasive alternative to open or minimally invasive surgical procedures. https://thejns.org/doi/10.3171/CASE2538.