Zhuang Haoxiang, Tan Haining, Lin Jisheng, Yang Yong, Fei Qi, Meng Hai
Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Xicheng District, China.
Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Xicheng District, China.
Int J Surg Case Rep. 2023 Sep;110:108648. doi: 10.1016/j.ijscr.2023.108648. Epub 2023 Aug 12.
Spinal epidural hematoma (SEH) is an uncommon condition that can result in severe neurological problems and needs to be treated as soon as possible. The incidence of traumatic SEH is 0.5 %-1.7 %, but increases to 9 % in patients with rheumatic diseases. Surgical treatment options include open surgery and minimally invasive surgery. We reported a post-traumatic SEH at T12/L1 level combined with L5 nerve injury and treated by UBE technique. To our knowledge, there was no reported cases like this.
A 38-year-old man with left leg weakness and severe back pain after fell down while cycling. Physical examination suggested left hip abduction was 2/5 strength, left dorsiflexion of hallux dorsal extension was 0/5 strength and the left ankle dorsiflexion was 2/5 strength. Magnetic resonance images (MRI) of lumbar spine showed a two-leveled hematoma extending from T12 to L1. After 1 year of surgery, the patient's symptoms had largely disappeared and he was able to perform daily activities independently.
An epidural hematoma at the L1 level is can cause symptoms of the L5 nerve root alone, which may be due to anatomical reasons. Complete removal of the epidural hematoma is necessary to restore the function of the nerve. We report a case of successful removal of an epidural hematoma using the UBE technique with good postoperative results.
The single nerve injury can occur with a thoracolumbar segmental hematoma, and UBE technology could be used to remove epidural hematoma.
脊髓硬膜外血肿（SEH）是一种罕见疾病，可导致严重的神经问题，需要尽快治疗。创伤性SEH的发病率为0.5%-1.7%，但在风湿性疾病患者中增至9%。手术治疗选择包括开放手术和微创手术。我们报告了一例T12/L1水平的创伤后SEH合并L5神经损伤并采用UBE技术治疗的病例。据我们所知，此前尚无此类病例报道。
一名38岁男性，在骑自行车摔倒后出现左腿无力和严重背痛。体格检查显示左髋外展肌力为2/5级，左足背屈背伸肌力为0/5级，左脚背屈肌力为2/5级。腰椎磁共振成像（MRI）显示一个从T12延伸至L1的两级血肿。术后1年，患者症状基本消失，能够独立进行日常活动。
L1水平的硬膜外血肿可单独引起L5神经根症状，这可能是由于解剖学原因。彻底清除硬膜外血肿对于恢复神经功能是必要的。我们报告了一例使用UBE技术成功清除硬膜外血肿且术后效果良好的病例。
胸腰段节段性血肿可发生单一神经损伤，UBE技术可用于清除硬膜外血肿。
