Rare Huge Epidural Hematoma Associated with Re-fracture of Kummell Disease: A Case Report and Literature Review

Abstract

Background Kummell disease combined with huge spinal epidural hematoma is a very rare phenomenon, and its potential pathogenesis and natural course remain unclear.Case description We describe a rare case of Kummell disease with huge spinal epidural hematoma. A 75-year-old male was diagnosed with osteoporotic vertebral compression fractures and was treated conservatively. After suffering minor trauma again 8 days ago, he presented unbearable low back pain and activity restriction. Lumbar MRI showed that L1 vertebral had re-fracture and intervertebral vacuum cleft, and a huge spinal epidural hematoma extending from T12- L1. Due to the patient had no neurological deficits and unbearable low back pain, percutaneous vertebroplasty was performed, and pain was relieved significantly. The follow-up MRI showed that the hematoma almost disappeared 7 days after the operation.Conclusion Although extremely rare, there is a possibility of spinal epidural hematoma after re-fracture of Kummell disease, and it could be further confirmed via MRI and pathological examination. Timely operation is recommended, and the results are usually favorable.

Acute Paraparesis Caused by Spinal Epidural Fluid After Balloon Kyphoplasty for Traumatic Avascular Necrosis: A Case Report

“…Filling the IVC with bone cement can block the connection between the intravertebral cleft and the epidural space and aid in the spontaneous resolution of the hematoma over time. Bai et al 1) also reported that bone cement augmentation using PV not only alleviate pain effectively, restore vertebral body height, and reconstruct spinal stability, but also block the connection between the IVC and the epidural space, by filling the IVC with bone cement, and help in the spontaneous absorption of the spinal epidural hematoma.…”