Document Detail

Spontaneous resolution of tetraparesis because of postoperative cervical epidural hematoma.
MedLine Citation:
PMID:  21094465     Owner:  NLM     Status:  In-Process    
BACKGROUND CONTEXT: Symptomatic postoperative spinal epidural hematoma (PSEH) is a rare but potentially devastating postoperative complication, accounting for 0.1% to 0.2% of cases.
PURPOSE: To describe a patient with a PSEH that completely resolved, clinically and radiographically, without surgical treatment.
STUDY DESIGN: Case report and review of the literature.
METHODS: A 47-year-old man with no history of a bleeding disorder underwent anterior cervical interbody fusion for C5-C6 disc herniation. The dura was exposed through removal of the posterior longitudinal ligament, and extensive decompression of posterior osteophytes of C5 and C6 vertebral bodies was performed. The patient developed tetraparesis and respiratory distress rapidly in the postanesthesia care unit and was reintubated for assisted ventilation. The computed tomography (CT) scan revealed a very large ventral epidural hematoma compressing the dural sac from C1 to C6.
RESULTS: The patient was prepared for hematoma evacuation. However, the neurological symptoms and respiration problems began to resolve spontaneously before the surgery was started. The hematoma was markedly improved on the follow-up CT scan, and the patient was discharged 2 weeks after surgery without neurological deficit.
CONCLUSIONS: This case illustrates that an unpredictable extensive hematoma can occur after uneventful surgery of the cervical spine in low-risk patients. In case of the dural exposure with a creation of hidden and large epidural space, the spine surgeon must pay particular attention to the possibility of a PSEH during the early postoperative period.
Jae-Won Jang; Jung-Kil Lee; Bo-Ra Seo; Soo-Han Kim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The spine journal : official journal of the North American Spine Society     Volume:  10     ISSN:  1878-1632     ISO Abbreviation:  Spine J     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101130732     Medline TA:  Spine J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1-5     Citation Subset:  IM    
Copyright Information:
Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved.
Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences 501-757, Gwangju, Republic of Korea.
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