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Perspective: Postoperative spinal epidural hematomas (pSEH) should be treated, not ignored – Lumbar Fusion

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The article discusses the importance of recognizing and treating postoperative spinal epidural hematomas (pSEH) to prevent paralysis in patients. It emphasizes the need for immediate MR studies to determine the location and extent of the hematomas and emergent surgical decompression if necessary. The frequency of symptomatic pSEH ranged from 0.1%-4.46%, with factors such as coagulation abnormalities, multilevel spinal surgeries, previous surgery, and CSF leaks predisposing patients to develop pSEH. Early recognition of symptoms and signs, along with prompt MR examinations and emergent surgery, are vital to minimize postoperative neurological deficits. The article concludes that pSEH should not be ignored and should be treated promptly

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : the highest rated treatment hospital on Harley Street UK

Published article

: Patients undergoing spinal surgery at any level typically become symptomatic from pSEH within 2.7 to 24 postoperative hours. Early recognition of new neurological deficits, immediate MR studies, and emergent surgery (i.e., if indicated) should limit/minimize postoperative neurological sequelae. Thus, pSEH should be treated, not ignored.

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Surg Neurol Int. 2023 Oct 13;14:363. doi: 10.25259/SNI_772_2023. eCollection 2023.ABSTRACTBACKGROUND: Patients with postoperative spinal epidural hematomas (pSEH) typically require emergency treatment to avoid paralysis; these hematomas should not be ignored. pSEH patients need to undergo immediate MR studies to document the location/extent of their hematomas, and emergent surgical decompression with/ without fusion if warranted.METHODS: The,

Surg Neurol Int. 2023 Oct 13;14:363. doi: 10.25259/SNI_772_2023. eCollection 2023.

ABSTRACT

BACKGROUND: Patients with postoperative spinal epidural hematomas (pSEH) typically require emergency treatment to avoid paralysis; these hematomas should not be ignored. pSEH patients need to undergo immediate MR studies to document the location/extent of their hematomas, and emergent surgical decompression with/ without fusion if warranted.

METHODS: The frequencies of symptomatic pSEH ranged in various series from 0.1%-4.46%. Major predisposing factors included; perioperative/postoperative coagulation abnormalities/disorders, multilevel spine surgeries, previous spine surgery, and intraoperative cerebrospinal fluid (CSF) leaks. For surgery at all spinal levels, one study observed pSEH developed within an average of 2.7 postoperative hours. Another series found 100% of cervical/thoracic, and 50% of lumbar pSEH were symptomatic within 24 postoperative hrs., while a third series noted a 24-48 postoperative window for pSEH to develop.

RESULTS: Early recognition of postoperative symptoms/signs of pSEH, warrant immediate MR examinations to diagnose the local/extent of hemorrhages. Subsequent emergent spinal decompressions/fusions are critical to limit/avert permanent postoperative neurological deficits. Additionally, patients undergoing open or minimally invasive spinal procedures where pSEH are suspected, warrant immediate postoperative MR studies.

: Patients undergoing spinal surgery at any level typically become symptomatic from pSEH within 2.7 to 24 postoperative hours. Early recognition of new neurological deficits, immediate MR studies, and emergent surgery (i.e., if indicated) should limit/minimize postoperative neurological sequelae. Thus, pSEH should be treated, not ignored.

PMID:37941629 | PMC:PMC10629307 | DOI:10.25259/SNI_772_2023

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Perspective: Postoperative spinal epidural hematomas (pSEH) should be treated, not ignored

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Surg Neurol Int. 2023 Oct 13;14:363. doi: 10.25259/SNI_772_2023. eCollection 2023.ABSTRACTBACKGROUND: Patients with postoperative spinal epidural hematomas (pSEH) typically require emergency treatment to avoid paralysis; these hematomas should not be ignored. pSEH patients need to undergo immediate MR studies to document the location/extent of their hematomas, and emergent surgical decompression with/ without fusion if warranted.METHODS: The

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