J Korean Neurosurg Soc.  2013 Feb;53(2):125-128. 10.3340/jkns.2013.53.2.125.

Cervical Spinal Epidural Hematoma Following Cervical Posterior Laminoforaminotomy

• Choi JH
• Kim JS
• Lee SH

• KMID: 2190692
• DOI: http://doi.org/10.3340/jkns.2013.53.2.125

Abstract

A 65-year-old man who had lateral cervical disc herniation underwent cervical posterior laminoforaminotomy at C5-6 and C6-7 level right side. During the operation, there was no serious surgical bleeding event. After operation, he complained persistent right shoulder pain and neck pain. Repeated magnetic resonance image (MRI) showed diffuse cervical epidural hematoma (EDH) extending from C5 to T1 level right side and spinal cord compression at C5-6-7 level. He underwent exploration. There was active bleeding at muscular layer. Muscular active bleeding was controlled and intramuscular hematoma was removed. The patient's symptom was reduced after second operation. Symptomatic postoperative spinal EDH requiring reoperation is rare. Meticulous bleeding control is important before wound closure. In addition, if patient presents persistent or aggravated pain after operation, rapid evaluation using MRI and second look operation is needed as soon as possible.

Keyword

Cervical epidural hematoma; Posterior laminoforaminotomy; Cervical disc herniation; Postoperative bleeding; Reoperation

MeSH Terms

Hematoma
Hematoma, Epidural, Spinal
Hemorrhage
Humans
Magnetic Resonance Spectroscopy
Neck Pain
Reoperation
Shoulder Pain
Spinal Cord Compression

Figure

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  Fig. 1 Sagittal magnetic resonance image showing disc herniation at C5-6 and C6-7 level (white arrows).

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  Fig. 2 Axial magnetic resonance image showing foraminal disc herniation right side at C5-6 and C6-7 level (white arrow).

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  Fig. 3 Sagittal repeated magnetic resonance image showing epidural hematoma from C5 to T1 (white arrows).

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  Fig. 4 Axial magnetic resonance image showing cervical spinal epidural hematoma (white arrow) at C5-6 and C6-7 level and intramuscular hematoma (black arrow).

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