Hisamitsu Yoshinori, Uchikado Hisaaki, Makizono Takehiro, Miyagi Tomoya, Miyahara Takahiro
Department of Neurosurgery, Ichinomiya Neurosurgical Hospital, Hita, Japan.
Department of Neurosurgery, Uchikado Neuro-Spine Clinic, Fukuoka, Japan.
Surg Neurol Int. 2022 Nov 25;13:550. doi: 10.25259/SNI_967_2022. eCollection 2022.
Lumbar ligamentum flavum hematomas (LFHs) are rare. However, when they occur and contribute to epidural cauda equina compression, timely surgical intervention is frequently warranted.
A 69-year-old female presented with the left lower extremity sciatica and gait disturbance of 2 weeks' duration that ultimately evolved into a paraparesis/cauda equina syndrome. When the lumbar MRI revealed left-sided L4-L5 epidural compression attributed to a hemorrhage into the hypertrophied ligamentum flavum (HLF), she successfully underwent a bilateral fenestration/decompressive procedure. Pathologically, neovascularization and rupture of the ventral layers of the degenerated and thickened HLF contributed to the LFH.
Arterial neovascularization (i.e., arterial feeding vessels from paramuscular/prelaminar lumbar branches) contributed to a left-sided L4-L5 LFH that resulted in epidural cauda equina compression in a 69-year-old female. Following surgical focal fenestration/decompression, the patient's symptoms/signs resolved.
腰椎黄韧带血肿（LFH）较为罕见。然而，当它们发生并导致硬膜外马尾神经受压时，通常需要及时进行手术干预。
一名69岁女性出现持续2周的左下肢坐骨神经痛和步态障碍，最终发展为轻截瘫/马尾神经综合征。腰椎MRI显示左侧L4-L5硬膜外受压是由于肥厚的黄韧带（HLF）出血所致，她成功接受了双侧开窗/减压手术。病理检查显示，退变增厚的HLF腹侧层新生血管形成和破裂导致了LFH。
动脉新生血管形成（即来自腰肌旁/椎板前腰椎分支的动脉供血血管）导致一名69岁女性左侧L4-L5 LFH，进而引起硬膜外马尾神经受压。手术局部开窗/减压后，患者的症状/体征消失。
