Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
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Whole Lumbar Spinal Subdural Hematoma with Progressive Paraplegia after Lumbar Spinal Epidural Injection

요추 경막외 신경차단술 후 진행하는 하지마비를 동반한 전 요추 경막하 혈종

  • Choi, Byung-Wan (Department of Orthopedic Surgery, Inje University Haeundae Paik Hospital) ;
  • Park, Kyung-Gu (Department of Orthopedic Surgery, Inje University Haeundae Paik Hospital)
  • 최병완 (인제대학교 해운대백병원 정형외과) ;
  • 박경구 (인제대학교 해운대백병원 정형외과)
  • Received : 2019.12.16
  • Accepted : 2020.03.03
  • Published : 2021.04.30
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Abstract

Spinal hematomas are a rare but serious complication that is typically observed in the epidural space. Spinal subdural hematomas are a dangerous clinical situation because of their potential to cause significant compression of the neural elements and can be mistaken easily for spinal epidural hematomas. This paper reports a case of a severe whole lumbar subdural hematoma after a simple epidural injection that was treated with surgical decompression with excellent clinical results.

척추의 혈종은 응급 치료를 요하는 상태로 대부분 경막외에 발생한다. 경막하 혈종은 흔히 경막외 혈종으로 오진되어 보다 급격한 신경학적 증상의 진행을 유발할 수 있으므로 정확한 진단과 치료에 대한 이해가 없으면 심각한 합병증을 유발할 수 있다. 저자들은 흔히 시행하는 경막외 신경차단술 후 기저 질환 없이 전 요추에 심한 경막하 혈종이 발생하여 진행하는 신경증상을 보였고 수술적으로 치료하여 그 증례를 보고하고자 한다.

Keywords

References

  1. Kobayashi K, Imagama S, Ando K, Nishida Y, Ishiguro N. Acute non-traumatic idiopathic spinal subdural hematoma: radiographic findings and surgical results with a literature review. Eur Spine J. 2017;26:2739-43. https://doi.org/10.1007/s00586-017-5013-y
  2. Benyaich Z, Laghmari M, Lmejjati M, Aniba K, Ghannane H, Ait Benali S. Acute lumbar spinal subdural hematoma inducing paraplegia after lumbar spinal manipulation: case report and literature review. World Neurosurg. 2019;128:182-5. https://doi.org/10.1016/j.wneu.2019.05.002
  3. Ardebol J, Cahueque M, Lopez W, Azmitia E. Spontaneous thoracic spinal subdural hematoma associated with apixaban therapy. J Surg Case Rep. 2019;2019:rjz115. https://doi.org/10.1093/jscr/rjz115
  4. Maddali P, Walker B, Fisahn C, et al. Subdural thoracolumbar spine hematoma after spinal anesthesia: a rare occurrence and literature review of spinal hematomas after spinal anesthesia. Cureus. 2017;9:e1032.
  5. Berhouma M, Al Dahak N, Messerer R, Al Rammah M, Vallee B. A rare, high cervical traumatic spinal subdural hematoma. J Clin Neurosci. 2011;18:569-74. https://doi.org/10.1016/j.jocn.2010.07.127
  6. Jang WY, Lee JK, Moon KS, et al. Traumatic acute spinal subarachnoid hematoma. J Clin Neurosci. 2007;14:71-3. https://doi.org/10.1016/j.jocn.2005.12.046
  7. Rader JP. Chronic subdural hematoma of the spinal cord: report of a case. N Engl J Med. 1955;253:374-6. https://doi.org/10.1056/NEJM195509012530906
  8. Krishnan P, Banerjee TK. Classical imaging findings in spinal subdural hematoma - "Mercedes-Benz" and "Cap" signs. Br J Neurosurg. 2016;30:99-100. https://doi.org/10.3109/02688697.2015.1071319
  9. Braun P, Kazmi K, Nogues-Melendez P, Mas-Estelles F, Aparici-Robles F. MRI findings in spinal subdural and epidural hematomas. Eur J Radiol. 2007;64:119-25. https://doi.org/10.1016/j.ejrad.2007.02.014
  10. Kang HS, Chung CK, Kim HJ. Spontaneous spinal subdural hematoma with spontaneous resolution. Spinal Cord. 2000;38:192-6. https://doi.org/10.1038/sj/sc/3100967