Protzman Nicole M, Kapun Jennifer, Wagener Christopher
Clinical Education and Research, Coordinated Health, Allentown; and.
Orthopedics, Coordinated Health, Bethlehem, Pennsylvania.
J Neurosurg Spine. 2016 Feb;24(2):295-299. doi: 10.3171/2015.5.SPINE141191. Epub 2015 Oct 13.
A spinal subdural hematoma is a rare clinical entity with considerable consequences without prompt diagnosis and treatment. Throughout the literature, there are limited accounts of spinal subdural hematoma formation following spinal surgery. This report is the first to describe the formation of a spinal subdural hematoma in the thoracic spine following surgery at the cervical level. A 53-year-old woman developed significant paraparesis several hours after anterior cervical discectomy and fusion of C5-6. Expeditious return to operating room for anterior cervical revision decompression was performed, and the epidural hematoma was evacuated without difficulty. Postoperative imaging demonstrated a subdural hematoma confined to the thoracic level, and the patient was returned to the operating room for a third surgical procedure. Decompression of T1-3, with evacuation of the subdural hematoma was performed. Postprocedure, the patient's sensory and motor deficits were restored, and, with rehabilitation, the patient gained functional mobility. Spinal subdural hematomas should be considered as a rare but potential complication of cervical discectomy and fusion. With early diagnosis and treatment, favorable outcomes may be achieved.
脊髓硬膜下血肿是一种罕见的临床病症,若不及时诊断和治疗会产生严重后果。在整个文献中,关于脊柱手术后形成脊髓硬膜下血肿的报道有限。本报告首次描述了颈椎手术后胸椎出现脊髓硬膜下血肿的情况。一名53岁女性在C5 - 6前路颈椎间盘切除融合术后数小时出现明显的双下肢轻瘫。迅速返回手术室进行前路颈椎翻修减压,硬膜外血肿顺利清除。术后影像学检查显示硬膜下血肿局限于胸椎水平,患者再次返回手术室进行第三次手术。对T1 - 3进行减压并清除硬膜下血肿。术后,患者的感觉和运动功能障碍得以恢复,经过康复治疗,患者获得了功能活动能力。脊髓硬膜下血肿应被视为颈椎间盘切除融合术罕见但潜在的并发症。早期诊断和治疗可取得良好效果。