Abstract

Abstract Introduction: Primary epidural hematomas or “hematorrachis” are rare and less frequent in the lumbar region. It presents with acute onset of severe back pain and rapid development of signs of compression Objective: To report a case of lumbar extradural spontaneous hematoma with acute paraparesis. Case Report: A 65 year old male presented with acute back ache of 2weeks duration with Radicular pain and numbness of both feet. He had progressive asymmetrical weakness of the lower extremities without bowel/bladder involvement and inability to walk.Radiograph of spine shows Grade 1 listhesis of L4-L5.MRI of LS Spine s/o synovial cyst at L2-L3 level.Left Facet joint arthropathy L2-L3. Patient underwent L2 laminectomy with removal of synovial cyst and hematoma Results: The patient had motor improvement of grade 3 power in hip and knee flexors and EHL AND EDL.3 months follow up showed grade 4 of all lower limb muscles with sensory numbness present on L3-L4 and L4-L5. Conclusion: Spontaneous spinal extradural hematoma should be suspected in any patient who complains of local or referred spinal pain associated with acute limb weakness, sensory deficits, with or without cauda equina symptoms.

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