Full-Endoscopic Transforaminal Approach for Removal of a Spontaneous Spinal Epidural Hematoma

Wu, Zikang; Zhu, Yongjian; Chu, Lei; Cheng, Chun-Yuan; Chen, Chien‐Min; Hsu, Hui-Ting

doi:10.1016/j.wneu.2016.07.086

Cited by 13 publications

(7 citation statements)

References 35 publications

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“…We found two reports that described the similar use of full endoscopic removal of SSEHs at one vertebral level. We identified several other studies that utilized biportal endoscopic to remove multilevel SSEH[ 3 , 6 , 11 ] [ Table 1 ]. The advantages of the flexible neuroendoscope included that it was safer and easier to manipulate in the epidural space, particularly when threaded between multiple levels, and helped minimize the risks of inadvertently compressing the spinal cord (i.e., this pressure potentially increases if the hematoma is thicker than 5 mm).…”

Section: Discussionmentioning

confidence: 99%

Widespread spontaneous spinal epidural hematoma treated with a combined technique using a flexible neuroendoscope after hemilaminectomy: A case report

Choo,

Maeda,

Takemoto

et al. 2023

Surgical Neurology International

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Background: One-third of spinal epidural hematomas occur spontaneously, and these may be associated with the acute onset of severe paralysis. Here, we present a case of T4-L4 symptomatic spontaneous spinal epidural hematoma which was successfully removed using a flexible neuroendoscope after hemilaminectomy. Case Description: Using flexible neuroendoscopy, we successfully treated a T4-L4 spinal epidural hematoma in an 89-year-old Japanese female who spontaneously developed back pain and paraparesis. The hematoma was removed utilizing a hemilaminectomy at three vertebral levels (T11, T12, and L1), while the remaining hematoma debris was completely evacuated with flexible neuroendoscopy. Neurological improvement was observed immediately postsurgery. Conclusion: Flexible neuroendoscopy provided a less extensive surgical method for removing a T4-L4 spontaneous epidural hematoma.

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Section: Discussionmentioning

confidence: 99%

Widespread spontaneous spinal epidural hematoma treated with a combined technique using a flexible neuroendoscope after hemilaminectomy: A case report

Choo,

Maeda,

Takemoto

et al. 2023

Surgical Neurology International

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“…Most of the current literature reports on the treatment of spontaneous epidural hematomas and epidural hematomas after spinal surgery, and rear literature reports on the surgical treatment of TSEH. Wu et al [ 12 ] reported a 26-year-old man was diagnosed as L4-5 SEH and treated with a full endoscopic transforaminal approach, the radicular symptom disappeared soon after surgery. A 63-year-old man with three-leveled hematoma was reported by Kim, the patient was treated by biportal endoscopic spine surgery and could present normal activity of daily living after 3 month after surgery [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Unilateral bi-portal endoscopy for unilateral L5 nerve injury due to post-traumatic epidural hematoma at T12/L1 level: A case report and literature review

Zhuang

Tan

Lin

et al. 2023

International Journal of Surgery Case Reports

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“…In these studies, 30% of patients had residual neurological deficits. Moreover, it was reported that the hematoma can be evacuated efficiently by full-endoscopic transforaminal approach with minimal invasiveness [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous spinal epidural hematoma in a patient on acenocoumarol for valvular atrial fibrillation: A rare case report

El-Azrak

Noumairi

Oulalite

et al. 2021

Annals of Medicine and Surgery

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Introduction Spontaneous spinal epidural hematoma (SSEH) is a rare finding, but one with serious clinical implications. Oral anticoagulant drugs are known to be associated with the SSEH onset, particularly when combined with drugs increasing the bleeding risk. Case presentation We present the case of a 62-year-old female on acencoumarol for her atrial fibrillation complicating severe mitral stenosis with a history of Ketoprofen use for the onset of her first symptoms. She presented to our emergency room with paraplegia and sphincter disturbance. Spinal magnetic resonance imaging (MRI) revealed a posterior SSEH extended from T10 to T12 requiring an urgent decompression of the spinal cord by laminectomy performed within 48 hours from the symptom's onset. After 3 months of rehabilitation, the patient improves partially her muscular strength with mostly unchanged sensitive and sphincteric levels. Clinical discussion Vitamin K antagonists (VKA) use appears to be a high suspicion index for SSEH diagnosis resulting in earlier surgery and improving neurological outcome. Also, it is important to pay attention to the concomitant use of VKA and non-steroidal anti-inflammatory drugs which increase the risk of bleeding and may worsen the neurological outcome. Conclusion SSEH is a rare and serious finding which should be especially searched when a history of oral anticoagulation is reported in presence of neurological symptoms. A prompt and suitable management may improve the patient outcomes.

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Full-Endoscopic Transforaminal Approach for Removal of a Spontaneous Spinal Epidural Hematoma

Cited by 13 publications

References 35 publications

Widespread spontaneous spinal epidural hematoma treated with a combined technique using a flexible neuroendoscope after hemilaminectomy: A case report

Widespread spontaneous spinal epidural hematoma treated with a combined technique using a flexible neuroendoscope after hemilaminectomy: A case report

Unilateral bi-portal endoscopy for unilateral L5 nerve injury due to post-traumatic epidural hematoma at T12/L1 level: A case report and literature review

Spontaneous spinal epidural hematoma in a patient on acenocoumarol for valvular atrial fibrillation: A rare case report

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