Spinal subdural hematoma following lumbar decompressive surgery: a report of two cases.
Spinal subdural hematoma (SSDH) following spine surgery is an extremely rare condition, with only three cases being reported in the literature. Unintended durotomy has been associated with SSDH due to alterations of pressures in the dural compartments. The objective of the present report was to report two rare cases of acute SSDH developed after lumbar decompressive surgery. In one of the patients, the diagnosis of SSDH was followed by urgent hematoma evacuation via durotomy due to the patient's worsening neurological symptoms. In the second patient, the SSDH was treated conservatively due to the absence of severe or progressive motor or sensory deficits. In conclusion, emergency evacuation via durotomy is the treatment of choice for patients with SSDH and neurologic impairment. Conservative management may be indicated in selected cases with absent motor and sensory deficits.
Department of Orthopedic Surgery, Spine and Scoliosis Service, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, 10021, New York, NY, USA, mariolyk@yahoo.com.
Marios G
MG
Lykissas
Alexander
A
Aichmair
Richard J
RJ
Herzog
Joshua E
JE
Schroeder
Russel C
RC
Huang
James
J
Farmer
D000368:Aged; D019299:Decompression, Surgical / Q000009:adverse effects*; D046649:Hematoma, Subdural, Spinal / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013130:Spinal Stenosis / Q000150:complications* / Q000601:surgery*; D016896:Treatment Outcome