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经椎间孔硬膜外类固醇注射后穿刺抽吸治疗硬膜外血肿——一例报告

Epidural hematoma treated by aspiration after transforaminal epidural steroid injection - A case report.

作者信息

Kim Go Eun, Hong Sung Jun, Kang Sang Soo, Ki Ho Joon, Park Jae Hyun

机构信息

Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.

出版信息

Anesth Pain Med (Seoul). 2021 Apr;16(2):184-190. doi: 10.17085/apm.20085. Epub 2021 Apr 9.

DOI:10.17085/apm.20085
PMID:33845549
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8107249/
Abstract

BACKGROUND

Spinal epidural hematoma is rare condition that can rapidly develop into severe neurologic deficits. The pathophysiology of this development remains unclear. There are several case reports of emergency hematoma evacuations after epidural steroid injection.

CASE

We report on two patients who developed acute, large amounts of epidural hematoma without neurological deficits after transforaminal epidural steroid injection. After fluoroscopy guided aspiration for epidural hematoma was performed, neurological defects did not progress and the hematoma was shown to be absorbed on magnetic resonance imaging.

CONCLUSIONS

These reports are believed to be the first of treating epidural hematoma occurring after transforaminal epidural steroid injection through non-surgical hematoma aspiration. If large amounts of epidural hematoma are not causing neurological issues, it can be aspirated until it is absorbed.

摘要

背景

脊髓硬膜外血肿是一种罕见疾病，可迅速发展为严重神经功能缺损。这种发展的病理生理学仍不清楚。有几例关于硬膜外类固醇注射后紧急血肿清除的病例报告。

病例

我们报告了两名患者，他们在经椎间孔硬膜外类固醇注射后出现急性大量硬膜外血肿，但无神经功能缺损。在透视引导下对硬膜外血肿进行抽吸后，神经功能缺损未进展，磁共振成像显示血肿被吸收。

结论

这些报告被认为是首次通过非手术血肿抽吸治疗经椎间孔硬膜外类固醇注射后发生的硬膜外血肿。如果大量硬膜外血肿未引起神经问题，可以进行抽吸直至其被吸收。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bf/8107249/41d3694af0db/apm-20085f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bf/8107249/0fb764a02480/apm-20085f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bf/8107249/caf62f41991d/apm-20085f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bf/8107249/41d3694af0db/apm-20085f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bf/8107249/0fb764a02480/apm-20085f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bf/8107249/caf62f41991d/apm-20085f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9bf/8107249/41d3694af0db/apm-20085f4.jpg

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本文引用的文献

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Epidural hematoma development contralateral to dura after lumbar transforaminal epidural steroid injection.腰椎经椎间孔硬膜外类固醇注射后硬膜对侧发生硬膜外血肿。
Pain Manag. 2017 Sep;7(5):367-375. doi: 10.2217/pmt-2017-0012. Epub 2017 Sep 22.
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