Chung W H, Tan R L, Chiu C K, Kwan M K, Chan Cyw
Department of Orthopaedic Surgery, University of Malaya, Kuala Lumpur, Malaysia.
Malays Orthop J. 2020 Nov;14(3):170-173. doi: 10.5704/MOJ.2011.027.
Delayed post-operative spinal epidural haematoma (DPSEH) is diagnosed when the onset of symptoms is more than three days from the index surgery. DPSEH is a rare but serious complication of spinal surgery. Missed diagnosis will result in irreversible neurological deficit which may lead to permanent disabilities. We report two cases of DPSEH who presented with worsening neurological deficit four days after the index surgery. Magnetic resonance imaging (MRI) showed the presence of an epidural haematoma compressing the spinal cord. Surgical evacuation of haematoma were performed for both patients. Both patients experienced neurological improvement. Surgeons should have high index of suspicion to identify delayed onset of spinal epidural haematoma (SEH) and timely intervention should be taken to avoid irreversible neurological damage.
术后延迟性脊髓硬膜外血肿（DPSEH）是指症状出现距离初次手术超过三天时所诊断的情况。DPSEH是脊柱手术中一种罕见但严重的并发症。漏诊会导致不可逆转的神经功能缺损，这可能会导致永久性残疾。我们报告两例DPSEH病例，这两名患者在初次手术后四天出现神经功能缺损恶化。磁共振成像（MRI）显示存在硬膜外血肿压迫脊髓。两名患者均接受了血肿手术清除。两名患者的神经功能均有改善。外科医生应高度怀疑以识别脊髓硬膜外血肿（SEH）的延迟发作，并应及时进行干预以避免不可逆转的神经损伤。
