Repurposing a Hardy nasal speculum as a tubular retractor for minimally invasive lumbar microdiscectomy

Background: Tubular microdiscectomy is an established minimally invasive technique for lumbar disc herniation. However, access to dedicated commercial tubular retractors may be limited in resource-constrained settings. This technical note describes the adaptation of a Hardy nasal speculum as a tubular access device for lumbar microdiscectomy. Methods: A Hardy nasal speculum was repurposed as a tubular retractor during lumbar microdiscectomy in a single surgical case. The procedure included standard patient positioning, fluoroscopic localization, a limited posterior approach, tubular access using the adapted instrument, microscopic visualization, and conventional microsurgical decompression. Results: The adapted Hardy nasal speculum provided a stable working corridor that allowed microscopic visualization and removal of the lumbar disc fragment with adequate neural decompression. The procedure was completed without complications. The main technical limitation was the absence of a dedicated fixation mechanism and differences in geometry compared with purpose-built spinal tubular retractors. Conclusion: In this single case, the Hardy nasal speculum provided a feasible alternative for establishing a tubular surgical corridor during lumbar microdiscectomy. This adaptation may represent a practical frugal surgical solution when dedicated tubular retractors are unavailable. Further clinical experience is required to assess its reproducibility and safety.