Spinal Epidural Hematoma after Thoracolumbar Posterior Fusion Surgery without Decompression for Thoracic Vertebral Fracture
We present a rare case of spinal epidural hematoma (SEH) after thoracolumbar posterior fusion without decompression surgery for a thoracic vertebral fracture. A 42-year-old man was hospitalized for a thoracic vertebral fracture caused by being sandwiched against his back on broken concrete block. Co...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2016/6295817 |
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| author | Tsuyoki Minato Masayuki Miyagi Wataru Saito Shintaro Shoji Toshiyuki Nakazawa Gen Inoue Takayuki Imura Hiroaki Minehara Terumasa Matsuura Tadashi Kawamura Takanori Namba Naonobu Takahira Masashi Takaso |
| author_facet | Tsuyoki Minato Masayuki Miyagi Wataru Saito Shintaro Shoji Toshiyuki Nakazawa Gen Inoue Takayuki Imura Hiroaki Minehara Terumasa Matsuura Tadashi Kawamura Takanori Namba Naonobu Takahira Masashi Takaso |
| author_sort | Tsuyoki Minato |
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| description | We present a rare case of spinal epidural hematoma (SEH) after thoracolumbar posterior fusion without decompression surgery for a thoracic vertebral fracture. A 42-year-old man was hospitalized for a thoracic vertebral fracture caused by being sandwiched against his back on broken concrete block. Computed tomography revealed a T12 dislocation fracture of AO type B2, multiple bilateral rib fractures, and a right hemopneumothorax. Four days after the injury, in order to promote early orthostasis and to improve respiratory status, we performed thoracolumbar posterior fusion surgery without decompression; the patient had back pain but no neurological deficits. Three hours after surgery, he complained of acute pain and severe weakness of his bilateral lower extremities; with allodynia below the level of his umbilicus, postoperative SEH was diagnosed. We performed immediate revision surgery. After removal of the hematoma, his symptoms improved gradually, and he was discharged ambulatory one month after revision surgery. Through experience of this case, we should strongly consider the possibility of preexisting SEH before surgery, even in patients with no neurological deficits. We should also consider perioperative coagulopathy in patients with multiple trauma, as in this case. |
| format | Article |
| id | doaj-art-ced2eba984d14600858ae3ca3c61d402 |
| institution | OA Journals |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-ced2eba984d14600858ae3ca3c61d4022025-08-20T02:19:30ZengWileyCase Reports in Orthopedics2090-67492090-67572016-01-01201610.1155/2016/62958176295817Spinal Epidural Hematoma after Thoracolumbar Posterior Fusion Surgery without Decompression for Thoracic Vertebral FractureTsuyoki Minato0Masayuki Miyagi1Wataru Saito2Shintaro Shoji3Toshiyuki Nakazawa4Gen Inoue5Takayuki Imura6Hiroaki Minehara7Terumasa Matsuura8Tadashi Kawamura9Takanori Namba10Naonobu Takahira11Masashi Takaso12Department of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, JapanDepartment of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, JapanDepartment of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, JapanDepartment of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, JapanDepartment of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, JapanDepartment of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, JapanDepartment of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, JapanDepartment of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, JapanDepartment of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, JapanDepartment of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, JapanDepartment of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, JapanDepartments of Biomedical Engineering and Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara 252-0373, JapanDepartment of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, JapanWe present a rare case of spinal epidural hematoma (SEH) after thoracolumbar posterior fusion without decompression surgery for a thoracic vertebral fracture. A 42-year-old man was hospitalized for a thoracic vertebral fracture caused by being sandwiched against his back on broken concrete block. Computed tomography revealed a T12 dislocation fracture of AO type B2, multiple bilateral rib fractures, and a right hemopneumothorax. Four days after the injury, in order to promote early orthostasis and to improve respiratory status, we performed thoracolumbar posterior fusion surgery without decompression; the patient had back pain but no neurological deficits. Three hours after surgery, he complained of acute pain and severe weakness of his bilateral lower extremities; with allodynia below the level of his umbilicus, postoperative SEH was diagnosed. We performed immediate revision surgery. After removal of the hematoma, his symptoms improved gradually, and he was discharged ambulatory one month after revision surgery. Through experience of this case, we should strongly consider the possibility of preexisting SEH before surgery, even in patients with no neurological deficits. We should also consider perioperative coagulopathy in patients with multiple trauma, as in this case.http://dx.doi.org/10.1155/2016/6295817 |
| spellingShingle | Tsuyoki Minato Masayuki Miyagi Wataru Saito Shintaro Shoji Toshiyuki Nakazawa Gen Inoue Takayuki Imura Hiroaki Minehara Terumasa Matsuura Tadashi Kawamura Takanori Namba Naonobu Takahira Masashi Takaso Spinal Epidural Hematoma after Thoracolumbar Posterior Fusion Surgery without Decompression for Thoracic Vertebral Fracture Case Reports in Orthopedics |
| title | Spinal Epidural Hematoma after Thoracolumbar Posterior Fusion Surgery without Decompression for Thoracic Vertebral Fracture |
| title_full | Spinal Epidural Hematoma after Thoracolumbar Posterior Fusion Surgery without Decompression for Thoracic Vertebral Fracture |
| title_fullStr | Spinal Epidural Hematoma after Thoracolumbar Posterior Fusion Surgery without Decompression for Thoracic Vertebral Fracture |
| title_full_unstemmed | Spinal Epidural Hematoma after Thoracolumbar Posterior Fusion Surgery without Decompression for Thoracic Vertebral Fracture |
| title_short | Spinal Epidural Hematoma after Thoracolumbar Posterior Fusion Surgery without Decompression for Thoracic Vertebral Fracture |
| title_sort | spinal epidural hematoma after thoracolumbar posterior fusion surgery without decompression for thoracic vertebral fracture |
| url | http://dx.doi.org/10.1155/2016/6295817 |
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