Symptomatic epidural hematoma after lumbar decompression surgery

Kao, Fu-Cheng; Tsai, Tsung-Ting; Chen, Lih-Huei; Lai, Po‐Liang; Fu, Tsai-Sheng; Niu, Chi‐Chien; Ho, Natalie Yi-Ju; Chen, Wen-Jer; Chang, Chee‐Jen

doi:10.1007/s00586-014-3297-8

Cited by 95 publications

(131 citation statements)

References 27 publications

Supporting

Mentioning

123

Contrasting

Unclassified

Order By: Relevance

“…[14,30] TA inhibits fibrinolysis and stabilizes blood clot, thereby decreasing the epidural and subcutaneous hematoma formation. [14,19] All patients were followed-up for more than 35 days after the operation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tranexamic acid reduces perioperative blood loss of posterior lumbar surgery for stenosis or spondylolisthesis

Shi

Jiang

et al. 2017

Medicine

View full text Add to dashboard Cite

Background:A prospective, randomized, double-blind, placebo-controlled study was performed. The routine usage of TA in spinal surgery is controversial. Only a few studies have focused on patients undergoing posterior lumbar surgery for stenosis or spondylolisthesis, although a large clinical cohort exists in the population. This study aimed to evaluate the effect and safety of TA in reducing perioperative blood loss in posterior lumbar surgery for stenosis or spondylolisthesis.Methods:100 eligible patients out of 126 were randomized to receive either a bolus dose of 30 mg/kg TA i.v, a maintenance dosage of 2 mg/kg/h TA, or an equivalent volume of normal saline. The pedicle screw system was used for fixing in all the patients, followed by decompression and posterior lumbar interbody fusion. The primary outcomes were intraoperative estimated blood loss and total blood loss. The secondary outcomes were receiving packed red blood cells and postoperative hemoglobin and hematocrit levels.Results:In total, 4 patients were excluded from the analyses, 50 patients were in the TA group, and 46 in the placebo group. The demographic and baseline data between the groups were not statistically different. The intraoperative estimated blood loss and the total blood loss were 33% and 41% lower in the TA group than the placebo group, respectively. The blood transfusion rate did not vary significantly (P = 0.191). Except a patient with a dural tear in the placebo group, no other complications were observed.Conclusion:TA significantly reduced the perioperative blood loss in patients undergoing posterior lumbar surgery for stenosis or spondylolisthesis.

show abstract

Section: Discussionmentioning

confidence: 99%

“…[14,19] All patients were followed-up for more than 35 days after the operation. Any hematoma formation in either of the groups, due to the low incidence of hematoma, was not seen [30] ; since the sample size was small, the difference may be not discovered.…”

Section: Discussionmentioning

confidence: 99%

Tranexamic acid reduces perioperative blood loss of posterior lumbar surgery for stenosis or spondylolisthesis

Shi

Jiang

et al. 2017

Medicine

View full text Add to dashboard Cite

show abstract

“…Several prior reports have noted that the use of oxidized cellulose and gelatin matrix could elicit neurological deficits or increase the risk of epidural hematoma after spinal surgery [28]. [29] [30] Regardless, surgeons need to be judicious in their use of hemostatic agents during spinal surgeries. One patient underwent reoperation due to a delayed CSF leakage (29 days after index surgery).…”

Section: Causes Of 30-day Reoperationmentioning

confidence: 99%

A multi-center study of reoperations within 30 days of spine surgery

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Symptomatic epidural haematoma after cervical laminoplasty 123 haematoma include preoperative factors (drinking >10 units of alcohol a week, previous spinal surgery, anticoagulant therapy, and hypertension), [3][4][5][6]8 intraoperative factors (multilevel procedures, 4 surgery on the thoracic spine, 1 and large intra-operative blood loss 10 ), and postoperative factors (use of non-steroidal anti-inflammatory drugs 6 and malfunction of the closed-suction drain 6,11 ). In our series, only patient 1 had previous spinal surgery and was prescribed anticoagulant therapy, but all 3 were prescribed antihypertensive medication.…”

Section: Vol 24 No 1 April 2016mentioning

confidence: 99%