Symptomatic Postoperative Epidural Hematoma in the Lumbar Spine.
Publication/Presentation Date
11-1-2022
Abstract
A symptomatic postoperative epidural hematoma (SPEH) in the lumbar spine is a complication with variable presentation and the potential to rapidly cause an irrecoverable neurological injury. Significant heterogeneity exists among current case series reporting SPEH in the literature. This review attempts to clarify the known incidence, risk factors, and management pearls. Currently, literature does not support the efficacy of subfascial drains in reducing the incidence of SPEHs and possibly suggests that medication for thromboembolism prophylaxis may increase risk. Acute back pain and progressing lower extremity motor weakness are the most common presenting symptoms of SPEH. Magnetic resonance imaging is the mainstay of diagnostic imaging necessary to confirm the diagnosis, but if not acutely available, an immediate return to the operative theater for exploration without advanced imaging is justified. Treatment of a SPEH consists of emergent hematoma evacuation as a delay in repeat surgery has a deleterious effect on neurological recovery. Outcomes are poorly defined, though a significant portion of patients will have lasting neurological impairments even when appropriately recognized and managed.
Volume
35
Issue
9
First Page
354
Last Page
362
ISSN
2380-0194
Published In/Presented At
Butler, A. J., Donnally, C. J., 3rd, Goz, V., Basques, B. A., Vaccaro, A. R., & Schroeder, G. D. (2022). Symptomatic Postoperative Epidural Hematoma in the Lumbar Spine. Clinical spine surgery, 35(9), 354–362. https://doi.org/10.1097/BSD.0000000000001278
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
34923504
Department(s)
Administration and Leadership
Document Type
Article