Lumbar epidural hematoma following lumbar puncture: the role of high dose LMWH and late surgery. A case report

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Gurkanlar D., Acikbas C., Cengiz G. K., Tuncer R.

NEUROCIRUGIA, vol.18, no.1, pp.52-55, 2007 (SCI-Expanded, Scopus)

  • Publication Type: Article / Article
  • Volume: 18 Issue: 1
  • Publication Date: 2007
  • Doi Number: 10.1016/s1130-1473(07)70312-3
  • Journal Name: NEUROCIRUGIA
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.52-55
  • Keywords: lumbar, epidural hematoma, surgery, LMWH, myelography, SPINAL-CORD, REGIONAL ANESTHESIA, COMPRESSION, MANAGEMENT, ANALGESIA, THERAPY, HEPARIN, RISK
  • Open Archive Collection: AVESIS Open Access Collection
  • Akdeniz University Affiliated: Yes

Abstract

Spinal epidural hematoma (SEH) is a known complication of spinal surgery, but the incidence of post-surgical SEHs that result in neurologic deficits is extremely rare (0.1%). Patients that require multilevel lumbar procedures and/or have a preoperative coagulopathy are at a significantly higher risk of developing an epidural hematoma. The introduction of higher dose of low molecular weight heparin (LMWH) twice daily 30 mg regimen) increased the reported incidence of neuroaxial hematomas. Surgery performed within 8 hours makes good or partial recovery of neurologic function.