Spontaneous spinal hematoma

Abstract

Background. Spontaneous spinal hematoma (SSH) is a rare condition that can result in severe functional disability and even death. But early detection and prompt intervention can substantially reduce the morbidity. We present a series of seven operated cases of SSH. Methods. All operated cases of SSH between 2017 and 2019 were studied. The demographic and clinical features, risk factors and imaging features were analyzed. The functional outcome at discharge and 6 months were assessed. Results. Seven operated cases of SSH with mean age 35(SD-20.9) were studied. Six cases were spontaneous spinal extradural hematomas (SSEDH) and one case was spontaneous spinal subdural hematoma (SSSDH). The most common site was cervicothoracic. Risk factors associated with SSH were thrombocytopenia, pregnancy, and necrotising pancreatitis. Two patients had preoperative Frankel’s grade A-B, three had grade C and two had D. The mean interval between the onset of symptoms and surgery was 4.7days. The functional outcome was dependent on the pre-operative functional status of the patient. Patients with SSEDH and thrombocytopenia had a poor outcome. Conclusion. SSH even though spontaneous may be associated with risk factors. The presence of thrombocytopenia and preoperative functional status predicted outcome. This is the only single institution case series to report thrombocytopenia as a factor predicting poor outcome.