Related Experiment Video
Updated: Jul 25, 2025
04:19
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
485
Post-traumatic spinal hematoma in diffuse idiopathic skeletal hyperostosis (DISH).
Riku M Vierunen1, Ville V Haapamäki2, Mika P Koivikko2
1Department of Radiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, 00029, Helsinki, Finland. riku.vierunen@hus.fi.
European Radiology
|June 29, 2023
Summary
Spinal epidural hematoma (SEH) is common after low-energy trauma in patients with diffuse idiopathic skeletal hyperostosis (DISH) and spinal ankylosis. Untreated SEH causing spinal cord impingement can lead to spinal cord injury (SCI).
Area of Science:
- Radiology
- Neurosurgery
- Orthopedic Surgery
Background:
- Diffuse idiopathic skeletal hyperostosis (DISH) causes spinal ankylosis, increasing fracture risk.
- Traumatic injuries in DISH patients can lead to severe neurological deficits.
Purpose of the Study:
- To determine the incidence of spinal hematoma after trauma in patients with DISH-related spinal ankylosis.
- To investigate the relationship between spinal hematoma and neurological deficits, including spinal cord injury (SCI).
Main Methods:
- Retrospective review of 70 DISH patients with spinal trauma undergoing CT and MRI.
- Analysis of spinal hematoma, spinal cord impingement, SCI, trauma mechanisms, fracture types, and treatment outcomes.
- Blinded review of MRI scans by two trauma radiologists.
Main Results:
- 49% of DISH patients with spinal trauma developed spinal epidural hematoma (SEH).
- 67% experienced spinal cord impingement, and 61% had SCI.
- Low-energy trauma, particularly ground-level falls, was the most common mechanism, often causing type B vertebral fractures.
Conclusions:
- SEH is a frequent complication in post-traumatic DISH patients with spinal ankylosis.
- Spinal cord impingement from SEH requires prompt decompression to prevent SCI.
- MRI is crucial for diagnosing spinal cord injury and identifying hematomas needing surgical intervention.
