Postoperative Symptomatic Anterior Spinal Epidural Hematoma

Abstract

N/A.

Multilevel Cervical Epidural Hematoma After C5-6 Anterior Cervical Discectomy and Fusion: The Cry of a Neurosurgeon

“…One of the interesting radiological findings in our patient was that the thickest part of the EDH was found on the upper cervical spine although the patient’s head was in an elevated position at almost 45 degrees on the bed. We must agree with authors who experienced similar complications that wide decompression and placement of the PEEK cage resulted in hidden and large epidural space in which unnoticed or small injury to the plexus bled and filled the enlarged epidural space [ 3 , 4 , 7 ]. The bleeding did not stop because of the wide epidural space made by surgical decompression and went to the upper cervical levels.…”

“…Cervical anterior EDH is an uncommon complication related to ACDF and is generally confined to the primary surgical site. Anterior bleeding far from the surgical site or multilevel EDH in the cervical spine is very rare with a few cases reported in the literature [3][4][5][6][7]. Several risk factors are well-known by neurosurgeons, among which preoperative coagulopathies and multilevel surgical procedures are considered significant risk factors [8,9].…”

“…Some studies have suggested that revision of the previous surgical site should be the first choice [ 4 , 11 , 12 ]. Epidural placement of urinary [ 7 ] or lumbar catheter [ 4 ] for the removal of epidural blood by continuous saline irrigation has been reported. Other studies have advocated posterior decompression and blood evacuation [ 1 ].…”