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Spinal epidural hematoma after pain control procedure.

Kyoung Hyup Nam1, Chang Hwa Choi, Moon Seok Yang

  • 1Department of Neurosurgery, School of Medicine, Pusan National University, Busan, Korea.

Journal of Korean Neurosurgical Society
|November 18, 2010
PubMed
Summary

Spinal epidural hematoma is a rare complication after pain control procedures. Early recognition and surgical evacuation can lead to good recovery, but caution is advised during procedures.

Keywords:
Pain control procedureSpinal epidural hematomaSurgical evacuation

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Area of Science:

  • Neurology
  • Neurosurgery
  • Pain Management

Background:

  • Spinal epidural hematoma (SEH) is a rare but serious complication following spinal interventions.
  • Pain control procedures like facet blocks and epidural injections carry a risk of SEH.
  • Acute myelopathy can result from SEH, potentially requiring surgical intervention.

Observation:

  • This report details four cases of SEH occurring after pain management procedures (two facet joint blocks, two epidural blocks).
  • Initial symptoms predominantly included pain, with two patients experiencing neurological deficits post-procedure.
  • Two patients underwent surgical hematoma evacuation, while the other two improved with conservative management.

Findings:

  • Three out of four patients achieved near-complete recovery.
  • One patient experienced residual deficits despite treatment.
  • SEH can cause significant spinal cord compression if not managed promptly.

Implications:

  • Spinal epidural hematoma, though rare, necessitates careful consideration during pain control procedures.
  • Prompt diagnosis and appropriate management, including surgical evacuation when indicated, are crucial for favorable outcomes.
  • Awareness of this complication is vital for clinicians performing spinal interventions.