Postoperative spinal epidural hematoma (SEH): incidence, risk factors, onset, and management

Large Increase in Blood Pressure After Extubation and High Body Mass Index Elevate the Risk of Spinal Epidural Hematoma After Spinal Surgery

“…[1][2][3][4][5] Although symptomatic SEH is relatively rare, 6 SEH occasionally causes clinically evident compression of the spinal cord or a nerve root, resulting in a need for surgical evacuation, hemostasis, or additional decompression surgery. [7][8][9] The reported incidence of symptomatic postoperative SEH requiring surgical treatment is only 0.1% to 0.4%. [7][8][9][10][11][12] When postoperative SEH causes severe neurological symptoms such as paralysis or bowel dysfunction, surgical intervention should be performed as early as possible to prevent a poor outcome.…”

“…[7][8][9] The reported incidence of symptomatic postoperative SEH requiring surgical treatment is only 0.1% to 0.4%. [7][8][9][10][11][12] When postoperative SEH causes severe neurological symptoms such as paralysis or bowel dysfunction, surgical intervention should be performed as early as possible to prevent a poor outcome. [7][8][9] It is, therefore, important to be aware of the risk factors for postoperative SEH and ensure close monitoring after surgery.…”

“…3 , 9 , 10 , 12 However, the effects of other reported risk factors are still controversial, including advanced age, 3 , 10 rhesus-positive blood type, 10 alcohol consumption, 9 previous spinal surgery, 9 preoperative coagulopathy, 12 elevated international normalized ratio, 3 , 10 large volume of intraoperative blood loss, 10 and intraoperative hemoglobin level of less than 10 g/dL. 10 In this case-control study, patients who developed postoperative SEH requiring surgical evacuation were matched according to the number of levels of spinal decompression performed to identify factors other than a multilevel procedure that increased the risk of symptomatic postoperative SEH.…”

Acute Spontaneous Spinal Epidural Hematoma Secondary to Aspirin

“…6 Some predisposing factors are coagulopathy, arteriovenous malformation, anticoagulation, antiplatelet therapy, therapeutic thrombolysis for acute myocardial infarction, thrombocytopenia and conditions causing an increased intrathoracic/intra-abdominal pressure as in cough, sneezing, and Valsalva maneuver. [6][7][8][9][10][11][12] Traumatic SEH can be due to vertebral fractures, 13 postspinal surgeries, 14 lumbar puncture, 15 and any spinal intervention.…”

Symptomatic Epidural Haematoma after Cervical Laminoplasty: A Report of Three Cases

“…Symptomatic epidural haematoma after cervical laminoplasty 123 haematoma include preoperative factors (drinking >10 units of alcohol a week, previous spinal surgery, anticoagulant therapy, and hypertension), [3][4][5][6]8 intraoperative factors (multilevel procedures, 4 surgery on the thoracic spine, 1 and large intra-operative blood loss 10 ), and postoperative factors (use of non-steroidal anti-inflammatory drugs 6 and malfunction of the closed-suction drain 6,11 ). In our series, only patient 1 had previous spinal surgery and was prescribed anticoagulant therapy, but all 3 were prescribed antihypertensive medication.…”