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Surgical management of spontaneous spinal epidural hematoma

Authors
 Jun-Jae Shin  ;  Sung-Uk Kuh  ;  Yong-Eun Cho 
Citation
 European Spine Journal, Vol.15(6) : 998-1004, 2006 
Journal Title
 European Spine Journal 
ISSN
 1432-0932 
Issue Date
2006
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Hematoma, Epidural, Spinal/complications ; Hematoma, Epidural, Spinal/diagnosis ; Hematoma, Epidural, Spinal/surgery* ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurologic Examination ; Spinal Cord Compression/diagnosis ; Spinal Cord Compression/etiology ; Spinal Cord Compression/surgery ; Time Factors ; Treatment Outcome
Keywords
Epidural hematoma ; Cord injury ; Operative time interval ; Spine surgery
Abstract
Spontaneous spinal epidural hematoma (SSEH) is a rare disease entity; its causative factors and the factors determining the outcome are still controversial. We reviewed our clinical experiences and analyzed the various factors related to the outcome for SSEH. We investigated 14 patients (11 men and 3 women) who underwent hematoma removal for SSEH from April 1998 to August 2004. We reviewed age, gender, hypertension, anticoagulant use and the preoperative neurological status using the Japanese Orthopaedics Association score by examining medical records, operative records, pathology reports, and radiographies, retrospectively. We were checking for factors such as the degree of cord compression owing to hematoma and the extent and location of the hematoma. Most patients included in the study were in their twenties or fifties. Four hematoma were located in the cervical region (29%), three were cervicothoracic (21%), four were thoracic (29%) and three were in the lumbar (21%) region and also 12 were located at the dorsal aspect of the spinal cord. In all cases, the neurological outcome improved after the surgical operation. There was a statistically significant difference between the incomplete and complete neurological injury for the preoperative status (P<0.05). The neurological outcome was good in those cases that had their hematoma removed within 24 h (P<0.05). The patients with incomplete neurological injury who had a surgical operation performed within 12 h had an excellent surgical outcome (P<0.01). Spontaneous spinal epidural hematoma was favorably treated by the means of a surgical operation. The favorable factors for SSEH operations were incomplete neurological injury at the time of the preoperative status and the short operative time interval.
Files in This Item:
T200600326.pdf Download
DOI
10.1007/s00586-005-0965-8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kuh, Sung Uk(구성욱) ORCID logo https://orcid.org/0000-0003-2566-3209
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/109131
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