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Epidural Hematoma Following Cervical Spine Surgery.

TitleEpidural Hematoma Following Cervical Spine Surgery.
Publication TypeJournal Article
Year of Publication2017
AuthorsSchroeder GD, Hilibrand AS, Arnold PM, Fish DE, Wang JC, Gum JL, Smith ZA, Hsu WK, Gokaslan ZL, Isaacs RE, Kanter AS, Mroz TE, Nassr A, Sasso RC, Fehlings MG, Buser Z, Bydon M, Cha PI, Chatterjee D, Gee EL, Lord EL, Mayer EN, McBride OJ, Nguyen EC, Roe AK, P Tortolani J, D Stroh A, Yanez MY, K Riew D
JournalGlobal Spine J
Volume7
Issue1 Suppl
Pagination120S-126S
Date Published2017 Apr
ISSN2192-5682
Abstract

STUDY DESIGN: A multicentered retrospective case series.

OBJECTIVE: To determine the incidence and circumstances surrounding the development of a symptomatic postoperative epidural hematoma in the cervical spine.

METHODS: Patients who underwent cervical spine surgery between January 1, 2005, and December 31, 2011, at 23 institutions were reviewed, and all patients who developed an epidural hematoma were identified.

RESULTS: A total of 16 582 cervical spine surgeries were identified, and 15 patients developed a postoperative epidural hematoma, for a total incidence of 0.090%. Substantial variation between institutions was noted, with 11 sites reporting no epidural hematomas, and 1 site reporting an incidence of 0.76%. All patients initially presented with a neurologic deficit. Nine patients had complete resolution of the neurologic deficit after hematoma evacuation; however 2 of the 3 patients (66%) who had a delay in the diagnosis of the epidural hematoma had residual neurologic deficits compared to only 4 of the 12 patients (33%) who had no delay in the diagnosis or treatment ( = .53). Additionally, the patients who experienced a postoperative epidural hematoma did not experience any significant improvement in health-related quality-of-life metrics as a result of the index procedure at final follow-up evaluation.

CONCLUSION: This is the largest series to date to analyze the incidence of an epidural hematoma following cervical spine surgery, and this study suggest that an epidural hematoma occurs in approximately 1 out of 1000 cervical spine surgeries. Prompt diagnosis and treatment may improve the chance of making a complete neurologic recovery, but patients who develop this complication do not show improvements in the health-related quality-of-life measurements.

DOI10.1177/2192568216687754
Alternate JournalGlobal Spine J
PubMed ID28451483
PubMed Central IDPMC5400190