The clinical analysis of 29 patients in spontaneous intraspinal canal hematoma
10.3760/cma.j.issn.1671-0282.2019.02.018
- VernacularTitle:29例自发性椎管内血肿的诊断和治疗分析
- Author:
Weihua LIU
1
;
Kai ZHAO
;
Junwen WANG
;
Liwu JIAO
;
Kuan HUANG
;
Chao YOU
;
Suojun ZHANG
;
Kai SHU
;
Ting LEI
Author Information
1. 华中科技大学同济医学院附属同济医院神经外科
- Keywords:
Intraspinal canal hematoma;
Spontaneous;
pinal vascular disease;
Surgery;
Efficacy
- From:
Chinese Journal of Emergency Medicine
2019;28(2):219-222
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the management of spontaneous intraspinal hematoma.Methods From January 2011 to July 2018,29 cases with spontaneous intraspinal hematoma were admitted to our department.Date on etiology,clinical presentation,radiological features,treatment strategy and prognosis were analyzed retrospectively.The prognosis was assessed by American Spinal Injury Association impairment scale (ASIA) before and after the treatment.Results Total of 29 cases,only 10 cases (34.5％) revealed specific etiology,including 7 cases of spinal vascular malformation,2 of tumor apoplexy,1 of cavernous hemangioma.After 2 weeks of conservative treatment,3 patients with grade D and 3 patients with grade E were assessed for spinal function.The average interval from onset to surgery was(9.4±7.5) days,the ASIA after two weeks of the operation was as follows:5 patients were assessed at grade A,5 patients at grade C,8 patients at grade D and 4 patients at grade E.28 patients were followed up for (48.7±23.1) months on average,6 patients without surgery were E,22 cases with surgery were as follows:4 cases A,18 cases D/E.Conclusions The etiology of spontaneous intraspinal hematoma is hard to define even after complete preoperative examination and exploratory operation.The preoperative neurologic functions are important predicting factors for the prognosis of spontaneous intraspinal hematoma.For patients who had neurologic function deficit,surgical treatment should be performed urgently to remove the hematoma and release the decompression of spinal cord.The majority of these patients can achieve a positive prognosis after surgery.
