Acute spinal subdural hematoma complicating lumbar decompressive surgery.
Kok Chun Chang1, Dino Samartzis, Keith D K Luk
1Department of Orthopaedic & Traumatology, Queen Mary Hospital, University of Hong Kong, Pokfulam, Hong Kong SAR, China.
Evidence-Based Spine-Care Journal
|December 14, 2012
Summary
Acute spinal subdural hematoma (SSH) is a rare complication following lumbar spine surgery. Prompt diagnosis with MRI and surgical decompression are crucial for optimal patient recovery.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Neurology
Background:
- Lumbar spine surgery, including laminectomy and fusion, is performed for instability and stenosis.
- Acute spinal subdural hematoma (SSH) is a rare but serious complication.
- Timely recognition and management are critical for neurological outcomes.
Observation:
- A 59-year-old woman developed severe, intractable leg pain and progressive weakness post-lumbar surgery.
- Magnetic resonance imaging revealed an acute SSH at L2, compressing the thecal sac.
- The patient underwent emergency decompression and hematoma evacuation.
Findings:
- The patient experienced incapacitating pain and neurological deterioration after surgery.
- MRI confirmed SSH proximal to the surgical site.
- Partial neurological recovery was noted 6 weeks post-decompression.
Implications:
- Severe, disproportionate leg pain after spine surgery warrants consideration of SSH.
- Magnetic resonance imaging is the preferred diagnostic tool for SSH.
- Early surgical intervention is essential for improving neurological recovery in SSH cases.
