LUMBAR SPINAL CHRONIC EPIDURAL HEMATOMAS. A RARE PATHOLOGY, OFTEN UNDERESTIMATED

Abstract

Objective. The authors, reporting 3 cases operated on in the last 2 years, describe the clinical and radiological features of a relatively very rare pathology or complication, which is part of the elaborated universe of the degenerative lumbar spinal disease. By pointing out the probable etiology, they suggest the most appropriate treatment. Patients and methods.We report 3 cases of lumbar spinal chronic epidural hematomas. The patients, all males aged from 65 to 38, presented with an irritative pluriradiculopathy, low back pain, neurological deficits and intermittent caludication. All patients underwent X-ray, CT and MRI that showed the hematomas to be associated with a significant spinal degenerative disease and disk herniation. They have been operated on with a microsurgical technique and stabilized by intersomatic titanium cages. Results. The outcome, in a 6 months-2 years follow-up, was excellent. All the symptoms and neurological deficits disappeared. Conclusions. Lumbar spinal chronic epidural hematoma is hard to pre-surgically diagnose and infrequently reported with clarity by radiologists. Nevertheless, it is a pathology with precise radiological and histological features, and its etiology derived from a spontaneous, iatrogenic or traumatic bleeding, which is always venous.