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Chronic expanding hematoma after spinal surgery
Hiroyuki Tsuchie1, Naohisa Miyakoshi, Michio Hongo
1Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita 010-8543, Japan. tsuchie@doc.med.akita-u.ac.jp
The Spine Journal : Official Journal of the North American Spine Society
|September 21, 2010
Summary
A rare case of chronic expanding hematoma (CEH) occurred 24 years after spinal surgery. This delayed CEH highlights the importance of considering long-term complications following spine procedures.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Hematology
Background:
- Chronic expanding hematoma (CEH) is an exceptionally rare complication following spinal surgery.
- No prior cases of CEH have been documented in the literature occurring decades after initial spinal intervention.
Observation:
- A 71-year-old male presented with a gradually enlarging spinal mass 24 years post-thoracic laminectomy and tumor resection.
- The mass, first noted 5 years after surgery, progressively grew over 19 years, causing erosion of thoracic vertebrae.
Findings:
- Surgical resection of the mass confirmed a chronic expanding hematoma.
- Histopathology verified the diagnosis, with no recurrence observed at the 1-year follow-up.
- Vertebral erosion was noted, but the dura mater remained intact.
Implications:
- This case underscores that chronic expanding hematoma can manifest as a very late complication of spinal surgery.
- Clinicians should consider CEH in the differential diagnosis for spinal masses, irrespective of the time elapsed since the original surgery.
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