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Year : 2021  |  Volume : 54  |  Issue : 3  |  Page : 103-106

Lumbar spinal epidural hematoma without vertebral fracture causing cauda equina syndrome

1 Department of Orthopedic, Chi-Mei Medical Center, Taichung, Taiwan
2 Department of Orthopedic, Chi-Mei Medical Center; Department of Orthopedic, An-Nan Hospital, China Medical University, Taichung, Taiwan

Correspondence Address:
Kin-Weng Wong
Department of Orthopedic, Chi-Mei Medical Center, No. 901, Zhonghua Road, Yongkang District, Tainan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/fjs.fjs_170_20

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Spinal epidural hematoma (SEH) is a rare disease and may lead to spinal cord compression. It could be caused by trauma, including iatrogenic procedures such as spinal surgery or spinal anesthesia or by spontaneous events related to coagulopathy or arteriovenous malformation. Once SEH is suspected clinically and confirmed by image modalities, it should be emergently decompressed by surgical intervention. Prognosis depends on the rate of symptoms development, interval from symptom onset to surgery, level of spinal involvement, and degree of neurological deficits. Here, we report the case of a 79-year-old female who sustained a fall months before admission, presented with a 3-day history of back and bilateral lower limbs weakness. Radiography and magnetic resonance imaging demonstrated epidural hematomas at the level of T12 to L2 without associated vertebral fracture. An urgent decompressive laminectomy with blood clot removal was performed immediately. Postoperatively, her neurologic deficits improved significantly except for residual numbness.

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