Delayed Epidural Hematoma After Spinal Surgery A Report of 4 Cases
- 1 December 2006
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Spinal Disorders & Techniques
- Vol. 19 (8), 603-606
- https://doi.org/10.1097/01.bsd.0000211242.44706.62
Abstract
Symptomatic postoperative epidural hematoma is a rare and potentially devastating complication of spinal surgery. The overwhelming majority of reported cases have occurred in the immediate postoperative period. A recent publication defined the clinical entity of delayed postoperative epidural spinal hematoma as neurologic deterioration due to an epidural hematoma occurring at least 3 days after the index procedure. Only 2 such cases have been reported in the lumbar spine to date. Four cases of delayed postoperative spinal epidural hematoma were identified over a 6-year period among the spine surgeons at a single large academic institution. Each case involved the lumbar spine. The details of each patient's initial surgery, presentation, and hospital course were then gathered from a retrospective chart review. The 4 patients presented are unusual in their delayed symptomatic presentations of postoperative spinal epidural hematoma. Despite the longer time to onset, however, our patients exhibited many of the characteristics common to cases that presented in the acute postoperative period. The spine surgeon must remain vigilant for the possibility of postoperative spinal epidural hematoma in at-risk patients, even weeks after the original surgical procedure.Keywords
This publication has 8 references indexed in Scilit:
- Analysis of the risk factors for the development of post-operative spinal epidural haematomaThe Journal of Bone and Joint Surgery. British volume, 2005
- A Randomized Study of Closed Wound Suction Drainage for Extensive Lumbar Spine SurgerySpine, 2004
- Epidural Hematoma After Cervical Spine SurgeryJournal of Neurosurgical Anesthesiology, 2003
- Delayed postoperative spinal epidural hematomasThe Spine Journal, 2003
- Risk Factors for Spinal Epidural Hematoma After Spinal SurgerySpine, 2002
- Extended posture of lumbar spine precipitating cauda equina compression arising from a postoperative epidural clotJournal of Orthopaedic Science, 2001
- Case Report. Delayed Postoperative Epidural Hematoma Formation After Heparinization in Lumbar Spinal SurgeryJournal of SPINAL DISORDERS, 2000
- Surgical management of spinal epidural hematoma: relationship between surgical timing and neurological outcomeJournal of Neurosurgery, 1995