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Spinal Epidural Hematoma Producing Neural Compression After Bilateral Rod Fractures in Failed Long-Construct Fusion:
Amy L Xu1, Kevin C Mo, Jacob M Babu
1Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
Case:
A 75-year-old woman with remote history of T10-S1 spinal fusion with pelvic fixation presented with radicular back pain and numbness in the right lower extremity. Imaging showed bilateral rod fractures at L4-5 and a dorsal spinal epidural hematoma (SEH) with associated severe canal narrowing and cauda equina compression. The patient underwent bilateral L4-5 laminectomies, hematoma evacuation, reinforcement of multilevel nonunion, and implant replacement. Her symptoms resolved after the procedure.
Conclusion:
SEH is a rare complication that may occur secondary to failed spinal fusion and must be considered in the differential diagnosis of new or progressive neurological symptoms.
