Postoperative Epidural Hematomas in the Lumbar Spine.
Postoperative epidural hematomas are rare complications following lumbar spine surgery, but if they are not quickly identified and treated they can lead to permanent neurological deficits. Epidural hematomas occur in approximately 0.10%-0.24% of all spine surgeries, and despite the fact that multiple large studies have been performed attempting to identify risk factors for this complication, there is still significant debate about the effect of subfascial drains, postoperative anticoagulation, and antiplatelet medication on the incidence of postoperative hematoma. The purpose of this manuscript is to review the epidemiology, etiology, diagnosis, and treatment of patients who develop a postoperative lumbar epidural hematoma.
*Department of Orthopaedic Surgery, The Rothman Institute, Thomas Jefferson University, Philadelphia, PA †Department of Neurosurgery, The University of Kansas, Kansas City, KS.
Gregory D
GD
Schroeder
Mark F
MF
Kurd
Christopher K
CK
Kepler
Paul M
PM
Arnold
Alexander R
AR
Vaccaro
D000925:Anticoagulants / Q000627:therapeutic use; D004322:Drainage; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications / Q000209:etiology*; D011184:Postoperative Period; D012307:Risk Factors
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors