Full-endoscopic interlaminar removal of chronic lumbar epidural hematoma after spinal manipulation
Journal
Surgical Neurology International
Journal Volume
5
Journal Issue
Supplement
Pages
131106
Date Issued
2014
Author(s)
Abstract
Background: Spinal manipulation is widely used for low back pain treatments. Complications associated with spinal manipulation are seen. Lumbar epidural hematoma (EDH) is one of the complications reported in the literature. If lumbar chronic EDH symptoms are present, which are similar to those of a herniated nucleus pulposus, surgery may be considered if medical treatment fails. Percutaneous endoscopic discectomy utilizing an interlaminar approach can be successfully applied to those with herniated nucleus pulposus. We use the same technique to remove the lumbar chronic EDH, which is the first documented report in the related literature. Copyright:Methods: We present a case with chronic lumbar EDH associated with spinal manipulation. Neurologic deficits were noted on physical examination. We arranged for a full-endoscopic interlaminar approach to remove the hematoma for the patient with the rigid endoscopy (Vertebris system; Richard Wolf, Knittlingen, Germany).Results: After surgery, the patient's radiculopathy immediately began to disappear. Magnetic resonance imaging (MRI) follow-up 10 days after the surgery revealed no residual hematoma. No complications were noted during the outpatient department follow up.Conclusions: Lumbar EDH is a possible complication of spinal manipulation. Patient experiencing rapidly progressive neurologic deficit require early surgical evacuation, while conservative treatment may only be applied to those with mild symptoms. A percutaneous full-endoscopic interlaminar approach may be a viable alternative for the treatment of those with chronic EDH with progressive neurologic deficits. ? 2014. Po Cheng Y.
Subjects
Chronic epidural hematoma; Endoscopic; Interlaminar; Lumbar; Spinal manipulation
SDGs
Other Subjects
adult; Article; case report; endoscopic surgery; endoscopy; follow up; human; intervertebral diskectomy; low back pain; male; middle aged; neurologic disease; nuclear magnetic resonance imaging; orthopedic endoscope; orthopedic manipulation; outpatient care; physical examination; postoperative care; priority journal; radiculopathy; spinal hematoma; spinal manipulation; surgical approach; treatment outcome
Publisher
Medknow Publications
Type
journal article