Case reports: a rare cause of radicular complaints: ligamentum flavum hematoma

Hematomas in the lumbar ligamentum flavum are rare and may generate signs and symptoms of lumbar nerve root compression or neurogenic claudication similar to the far more common degenerative diseases. The pathogenesis of these hematomas is unclear. Ruptured irregular vessels of the degenerated and hypertrophic ligamentum flavum were assumed. We diagnosed three patients with a flavum hematoma intraoperatively leading to radicular complaints and spinal claudication. One occurred as a complication of local infiltration therapy, and the other two patients reported minor trauma as the releasing factor. Using spinal magnetic resonance imaging, a preoperative diagnosis is possible but the differentiation to synovial cysts is difficult. Surgical resection of the ligamentum flavum, including the hematoma, provided adequate treatment in these patients.