title: Spinal surgery in a patient with essential thrombocythemia resulting in leg paraplegia: a case report.
abstract: BACKGROUND
  Essential thrombocythemia (ET) is a chronic myeloproliferative disorder characterized by a relatively benign clinical course that may be complicated by conflicting thrombosis and bleeding. Postoperative spinal epidural hematoma is an uncommon, but well-known, complication after spinal surgery.
  
  
  OBJECTIVE
  To describe a patient with ET who underwent surgery for lumbar spinal canal stenosis resulting in leg paraplegia and discuss the perioperative management for ET.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  The patient with ET underwent laminoplasty and posterolateral fusion for degenerative spondylolisthesis and spinal stenosis at L4-L5. A hematoma was observed in the epidural cavity after surgery, and emergency surgical evacuation was performed. After revision surgery, bleeding from the wound continued for 2 months, despite transfusions of platelets and coagulation factors, and right unilateral leg paralysis developed.
  
  
  CONCLUSIONS
  This case presentation increases the awareness of this disorder to the spinal community and the need to establish guidelines for the perioperative management of patients who require surgery in similar settings.
authors.affiliation: Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, West 16, South 1, Chuo-ku, Sapporo 060-8543, Japan. Electronic address: emrmkt@yahoo.co.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Emori
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takebayashi
authors.forename: Kenshi
authors.initials: K
authors.lastname: Imoto
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Ueno
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mizuno
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamashita
mesh_terms: D000369:Aged, 80 and over; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D010264:Paraplegia / Q000209:etiology*; D013123:Spinal Fusion / Q000009:adverse effects*; D013130:Spinal Stenosis / Q000150:complications / Q000601:surgery*; D013920:Thrombocythemia, Essential / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome
keywords: Degenerative spondylolisthesis; Essential thrombocythemia; Postoperative spinal epidural hematoma