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Delayed Postoperative Spinal Epidural Hematoma after Cervical Laminoplasty
Masato Tomii1, Junichi Mizuno1, Ken Kazama1
1Department of Neurosurgery, Southern TOHOKU General Hospital, Iwanuma, Miyagi, Japan.
NMC Case Report Journal
|January 23, 2018
Summary
Delayed postoperative spinal epidural hematoma (DPSEH) can occur over a week after cervical surgery. Meticulous blood pressure control is crucial for over a week post-operation to prevent severe neurological deficits.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Neurology
Background:
- Cervical spondylosis is a degenerative condition affecting the cervical spine.
- Cervical laminoplasty is a surgical procedure to decompress the spinal cord.
- Postoperative spinal epidural hematoma (SEH) is a rare but serious complication.
Observation:
- A 56-year-old male developed sudden severe neck pain and rapid tetraplegia 7 days after cervical laminoplasty.
- Computed tomography revealed a large cervical epidural hematoma compressing the spinal cord.
- The patient had a history of poorly controlled blood pressure during the perioperative period.
Findings:
- Surgical evacuation of the hematoma was performed 3 hours after symptom onset.
- The patient's postoperative course was uneventful after hematoma evacuation.
- This case highlights the potential for delayed onset of spinal epidural hematoma.
Implications:
- Delayed postoperative spinal epidural hematoma (DPSEH) can manifest more than a week after spinal surgery.
- Sustained meticulous blood pressure control beyond the immediate postoperative period is essential.
- Awareness of DPSEH risk and vigilant monitoring are critical for neurosurgical and orthopedic spine surgeons.
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