Percutaneous drainage of a postoperative intraspinal hematoma using a Tuohy needle

Abstract

A 78-year-old man developed a large subdural hematoma extending from T12 to L3 levels following L3 laminectomy and L3-5 posterior spinal fusion. He had associated neurological signs and symptoms. MR imaging showed typical signal characteristics of a subacute intraspinal subdural hematoma. Percutaneous drainage was successfully performed under CT guidance by inserting a Tuohy needle through the L3 laminectomy defect. The catheter packaged with the Tuohy needle was inserted cranially into the hematoma and 30 ml of blood was aspirated. Follow-up MR imaging confirmed resolution of the hematoma and the patient made a rapid recovery.

Spinal subdural hematoma following cranial surgery: A case report and review of the literature

“…Of the nontraumatic SDHs, approximately half of them are associated with coagulopathy and iatrogenic factors, including lumbar puncture, spinal epidural anesthetic procedures, and spinal surgeries. [3,4] Underlying vascular malformation is the cause of SDH in a few cases [1,5] and in some cases no cause could be identified-idiopathic. [2] SDH rarely occurs after a cranial surgery.…”

“…[1] This complication usually occurs in the setting of spinal instrumentation or coagulopathy and only fewer cases have been reported as a complication of cranial surgery. [2][3][4] Case Report A 26-year-old man presented with 4 years history of intermittent headache and numbness of right face of 1 month duration. On neurologic examination, only slight hypoesthesia on the right side of the face was detected.…”

Drainage of an acute spinal epidural hematoma that developed without risk factors in the thoracic spine using epidural needle -A case report-

“…It is believed that immediate decompression within 36 hours is linked to good prognosis [8]. However, according to Cai et al reported for a few cases [11][12][13][14].…”

“…Lyu et al [13] have also reported that they have treated a 48-year-old man with severe pain who had walking and dysuria disorders by removing an epidural abscess with a needle guided by CT. In addition, after 30 cc of blood was removed from intraspinal hematoma after laminectomy using an 18-gauge Tuohy needle and catheter guided CT, complete resolution was achieved based on MRI and the patient was fully recovered in another study [14].…”