Commercial massage tool-induced spinal epidural hematoma

Area of Science:

• Neurology
• Emergency Medicine
• Medical Devices

Background:

• Spinal epidural hematoma (SEH) is a rare but potentially emergent condition.
• Cervical massage using commercial tools is increasingly common.
• The link between mechanical neck manipulation and SEH is not well-established.

Observation:

• A 75-year-old male presented with posterior neck pain after using a commercial massage tool.
• The patient exhibited hypotension, respiratory failure, and severe motor and sensory deficits.
• Symptoms spontaneously resolved within 2 hours.

Findings:

• Magnetic resonance imaging confirmed a spinal cord epidural hematoma at the C2/C3 to C3/C4 level.
• The patient recovered fully without sequelae and was discharged on day 6.
• Cervical massage with a commercial tool was identified as the likely cause.

Implications:

• This case underscores the potential for serious neurological injury from seemingly innocuous devices.
• Healthcare providers should inquire about the use of commercial massage tools in patients with neck pain or neurological deficits.
• Further research is needed to understand the risks associated with mechanical cervical manipulation devices.