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术后脊柱硬膜外血肿导致马尾综合征:一例病例报告及文献综述

Postoperative spinal epidural hematoma resulting in cauda equina syndrome: a case report and review of the literature.

作者信息

Kaner Tuncay, Sasani Mehdi, Oktenoglu Tunç, Cirak Bayram, Ozer Ali Fahir

机构信息

Department of Neurosurgery, Pendik State Hospital, Dr. Orhan Maltepe cd. No:17, Pendik, 34890, Istanbul, Turkey.

出版信息

Cases J. 2009 Jul 16;2:8584. doi: 10.4076/1757-1626-2-8584.

Abstract

Spinal epidural hematoma is a well known complication of spinal surgery. Clinically insignificant small epidural hematomas develop in most spinal surgeries following laminectomy. However, the incidence of clinically significant postoperative spinal epidural hematomas that result in neurological deficits is extremely rare. In this report, we present a 33-year-old female patient whose spinal surgery resulted in postoperative spinal epidural hematoma. She was diagnosed with lumbar disc disease and underwent hemipartial lumbar laminectomy and discectomy. After twelve hours postoperation, her neurologic status deteriorated and cauda equina syndrome with acute spinal epidural hematoma was identified. She was immediately treated with surgical decompression and evacuation of the hematoma. The incidence of epidural hematoma after spinal surgery is rare, but very serious complication. Spinal epidural hematomas can cause significant spinal cord and cauda equina compression, requiring surgical intervention. Once diagnosed, the patient should immediately undergo emergency surgical exploration and evacuation of the hematoma.

摘要

脊髓硬膜外血肿是脊柱手术一种广为人知的并发症。在大多数椎板切除术后的脊柱手术中会出现临床上无显著意义的小硬膜外血肿。然而,导致神经功能缺损的具有临床意义的术后脊髓硬膜外血肿的发生率极为罕见。在本报告中,我们介绍了一名33岁女性患者,其脊柱手术导致了术后脊髓硬膜外血肿。她被诊断为腰椎间盘疾病,并接受了半椎板腰椎切除术和椎间盘切除术。术后12小时,她的神经状态恶化,被确诊为马尾综合征伴急性脊髓硬膜外血肿。她立即接受了手术减压和血肿清除治疗。脊柱手术后硬膜外血肿的发生率虽低,但却是非常严重的并发症。脊髓硬膜外血肿可导致严重的脊髓和马尾受压,需要进行手术干预。一旦确诊,患者应立即接受紧急手术探查和血肿清除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c431/2740261/ba02f3ed7298/1757-1626-0002-0000008584-001.jpg

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