Retrospective Analysis of 14 Cases of Spinal Epidural Hematoma

Abstract

Objective: Spinal epidural hematoma (SEH) is rare diseases and they may have various causes. We reviewed our clinical experiences and analyzed the various factors related to the outcome for SEH. Methods: We investigated 14 patients (8 men and 6 women) who underwent hematoma removal for SEH from January 2003 to December 2010. We investigated age, gender, hypertension, anticoagulant use, radiographic finding such as the degree of cord compression and the extent and location of the hematoma and relationship between preoperative neurologic status, surgical timing and neurological outcome using the Japanese Orthopaedic Association (JOA) score by examining medical records. Results: In ten cases (71.4%) of operated 14 cases, there were post-operative improvements (recovery scale >50%) in clinical symptoms. We performed operation within 12 hour for seven cases, and the average of recovery scale for these cases was 69.9%. Six (85.7%) of these cases improved more than 50% on the recovery scale. There were seven cases that we performed operations on that were beyond 12 hour, and the average of the recovery scale was 47.7%. The average of the recovery scale in cases of incomplete injury after the operation was 64.4%, and the average of the recovery scale was 38.1% in cases of complete injury. There was a significant difference between two groups (p<0.05). Conclusion: Our present study demonstrates that surgical time interval and preoperative neurological status correlated with neurological recovery. The rapidity of surgical intervention and preoperative favorable neurological status maximize neurological recovery. (J Korean Neurotraumatol Soc 2011;7:51-56)