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Acute and Delayed Epidural Hematoma After Total Spondylectomy for a Metastatic Spinal Tumor -A Case Report -

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2019, 26(3), pp.94-99
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery
  • Published : September 30, 2019

Young Kyu Kim 1 김정훈 1

1인제대학교 일산백병원 정형외과학교실

Accredited

ABSTRACT

Study Design: Case report. Objectives: We report a case of recurrent spinal epidural hematoma after total spondylectomy for a metastatic spinal tumor. Summary of Literature Review: Postoperative epidural hematoma is rare, and no case of delayed epidural hematoma after hematoma removal has been reported. Materials and Methods: A 74-year-old woman experienced a ninth thoracic vertebral (T9) pathologic fracture caused by a metastatic spinal tumor and underwent total spondylectomy. Immediate postoperative epidural hematoma occurred and neurological symptoms appeared. After hematoma removal, the symptom improved. Ten days after surgery, the neurological symptoms worsened again. Spine magnetic resonance imaging showed delayed epidural hematoma. Hematoma removal was done again. Results: The patient’s neurological symptoms improved after delayed hematoma removal. Conclusions: Delayed hematoma that cause neurological symptoms may occur after primary hematoma removal. If neurological symptoms recur after hematoma removal, the surgeon should consider the possibility of hematoma recurrence. Before total spondylectomy surgery, preoperative embolization is recommended. Key Words: Delayed epidural hematoma, Metastatic spinal tumor, total spondylectomy

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