Delayed Onset Neurological Deterioration due to a Spinal Epidural Hematoma after a Spine Fracture.

Author: Jung Won HA ¹ ; Jin Oh PARK ; Eun Su MOON ; Chong Hyuk CHOI ; Ju Young KIM ; Hak Sun KIM ; Jeong Gil LEE
Author Information

1. Department of Orthopedic Surgery, National Health Insurance Corporation Ilsan Hospital, Koyang, Korea.
Publication Type:Case Report
Keywords: Spinal epidural hematoma; Spine fracture; Neurology
MeSH: Adult; Extremities; Hematoma; Hematoma, Epidural, Spinal*; Humans; Laminectomy; Magnetic Resonance Imaging; Male; Neurology; Spinal Fractures; Spine*
From:Asian Spine Journal 2007;1(2):98-101
CountryRepublic of Korea
Language:English
Abstract: There are no reports of a 7-day delay in the onset of neurological deterioration because of a spinal epidural hematoma (SEH) after a spinal fracture. A hematoma was detected from the T12 to L2 area in a 36-year-old male patient with a T12 burst fracture. On the same day, the patient underwent in situ posterior pedicle instrumentation on T10-L3 with no additional laminectomy. On the seventh postoperative day, the patient suddenly developed weakness and sensory changes in both extremities, together with a sharp pain. A MRI showed that the hematoma had definitely increased in size. A partial laminectomy was performed 12 hours after the onset of symptoms. Two days after surgery, recovery of neurological function was noted. This case shows that spinal surgeons need to be aware of the possible occurrence of a delayed aggravated SEH and neurological deterioration after a spinal fracture.