Full-Endoscopic Transforaminal Approach for Removal of a Spontaneous Spinal Epidural Hematoma
| Autor: | Chien-Min Chen, Yongjian Zhu, Zong-Yang Wu, Chun-Yuan Cheng, Hsu Hui-Ting, Lei Chu |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous medicine.medical_treatment Lumbar vertebrae 03 medical and health sciences 0302 clinical medicine Lumbar Back pain Medicine Humans Local anesthesia 030212 general & internal medicine Lumbar Vertebrae business.industry Laminectomy Endoscopy Spinal cord medicine.disease Decompression Surgical Hematoma Epidural Spinal Magnetic Resonance Imaging Surgery medicine.anatomical_structure Radicular pain Anesthesia cardiovascular system Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. 98 |
| ISSN: | 1878-8769 |
| Popis: | Background The incidence of spinal epidural hematoma (SEH) is estimated to be 1 per 1,000,000 patients per year; SEH can be classified as idiopathic, spontaneous, and secondary. The cause of spontaneous SEH is uncertain but it may be associated with minor trauma. SEH can compress surrounding structures, shown by clinical symptoms and signs that affect the spinal cord or nerve roots. Surgical treatment may be considered if medical treatment fails. Case Description A 26-year-old man presented with lower back pain and significant radicular symptoms on the left side for a week. He denied previous lumbar trauma or the use of anticoagulation drugs. We used the full-endoscopic transforaminal approach (extraforaminal technique) to remove the SEH under local anesthesia. The patient was discharged home 2 days after surgery and the radicular pain disappeared completely. Three months later, follow-up magnetic resonance imaging showed that the dark-brown lesion had been totally removed. Conclusions Spontaneous SEHs are uncommon. Although lumbar laminectomy is the mainstream treatment in those with neurologic deficits caused by epidural hematomas, the percutaneous full-endoscopic transforaminal approach may be an option for certain SEHs. |
| Databáze: | OpenAIRE |
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