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Dokuzović S, Španić M, Muthu S, Pavešić J, Ivandić S, Eder G, Bošnjak B, Prodan K, Lončar Z, Ćorluka S. Conservative Treatment for Spontaneous Resolution of Postoperative Symptomatic Thoracic Spinal Epidural Hematoma-A Case Report. Medicina (Kaunas) 2023; 59:1590. [PMID: 37763709 PMCID: PMC10534765 DOI: 10.3390/medicina59091590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023]
Abstract
Introduction: Postoperative epidural hematomas of the cervical and thoracic spine can pose a great risk of rapid neurological impairment and sometimes require immediate decompressive surgery. Case Report: We present the case of a young patient operated on for stabilization of a two-level thoracic vertebra fracture who developed total paralysis due to an epidural hematoma postoperatively. The course of epidural hematoma was quickly reversed with the help of a conservative technique that prevented revision surgery. The patient regained complete neurologic function very rapidly, and has been well on every follow-up to date. Conclusion: There is a role of similar maneuvers as described in this case to be employed in the management of postoperative epidural hematomas. However, prolonged watchful waiting should still be discouraged, and patients should remain ready for revision surgery if there are no early signs of rapid recovery.
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Affiliation(s)
- Stjepan Dokuzović
- Spinal Surgery Division, Department of Traumatology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia; (S.D.); (J.P.)
- Akromion Special Hospital for Orthopaedic Surgery, 49217 Krapinske Toplice, Croatia;
| | - Mario Španić
- Akromion Special Hospital for Orthopaedic Surgery, 49217 Krapinske Toplice, Croatia;
| | - Sathish Muthu
- Orthopaedic Research Group, Coimbatore 641045, Tamil Nadu, India;
- Department of Biotechnology, Faculty of Engineering, Karpagam Academy of Higher Education, Coimbatore 641021, Tamil Nadu, India
- Department of Orthopaedics, Government Medical College, Karur 639004, Tamil Nadu, India
| | - Jure Pavešić
- Spinal Surgery Division, Department of Traumatology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia; (S.D.); (J.P.)
| | - Stjepan Ivandić
- Traumatology Department, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia; (S.I.); (G.E.)
| | - Gregor Eder
- Traumatology Department, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia; (S.I.); (G.E.)
| | - Bogdan Bošnjak
- General Hospital, Croatian Veterans, 49210 Zabok, Croatia;
| | - Ksenija Prodan
- Clinical Department of Diagnostic and Interventional Radiology, Department of Traumatology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia;
| | - Zoran Lončar
- Anesthesiology, Intensive Care and Pain Management Division, Traumatology Department, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia;
| | - Stipe Ćorluka
- Spinal Surgery Division, Department of Traumatology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia; (S.D.); (J.P.)
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia
- Department of Anatomy and Physiology, University of Applied Health Sciences, 10000 Zagreb, Croatia
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