Epidural Hematoma Following Cervical Spine Surgery
Gregory D Schroeder1, Alan S Hilibrand1, Paul M Arnold2
1Jefferson Medical College, The Rothman Institute, Philadelphia, PA, USA.
Global Spine Journal
|April 29, 2017
Summary
Postoperative epidural hematoma after cervical spine surgery occurs in about 1 in 1000 cases. Prompt diagnosis and treatment may improve neurologic recovery, but quality of life may not improve.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Neurology
Background:
- Cervical spine surgery carries risks, including the rare but serious complication of postoperative epidural hematoma.
- Understanding the incidence and outcomes of this complication is crucial for patient safety and surgical planning.
Purpose of the Study:
- To determine the incidence and circumstances of symptomatic postoperative epidural hematoma in cervical spine surgery.
- To analyze the impact of diagnosis and treatment delays on patient outcomes.
Main Methods:
- A multicentered retrospective case series.
- Review of 16,582 cervical spine surgeries across 23 institutions from 2005 to 2011.
- Identification of patients who developed postoperative epidural hematoma.
Main Results:
- The overall incidence of postoperative epidural hematoma was 0.090% (15 of 16,582 surgeries).
- Significant institutional variation in incidence was observed.
- Patients with delayed diagnosis had a higher rate of residual neurologic deficits (66% vs. 33%).
- No significant improvement in health-related quality of life was noted post-hematoma evacuation.
Conclusions:
- Postoperative epidural hematoma is a rare complication of cervical spine surgery, occurring in approximately 1 in 1000 cases.
- Prompt diagnosis and treatment are associated with better neurologic recovery.
- Despite surgical intervention for hematoma, patients may not experience improvements in health-related quality of life.
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