کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4097297 1268585 2013 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Postoperative spinal epidural hematoma (SEH): incidence, risk factors, onset, and management
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی ارتوپدی، پزشکی ورزشی و توانبخشی
پیش نمایش صفحه اول مقاله
Postoperative spinal epidural hematoma (SEH): incidence, risk factors, onset, and management
چکیده انگلیسی

Background contextSpinal epidural hematoma (SEH) is a rare, yet potentially devastating complication of spinal surgery. There is limited evidence available regarding the risk factors and timing for development of symptomatic SEH after spinal surgery.PurposeTo assess the incidence, risk factors, time of the onset, and effect of early evacuation of symptomatic SEH after spinal surgery.Study designMulticenter case control study.Patient sampleAll patients who underwent open spinal surgery between October 1, 1999, and September 30, 2006, at the National Hospital For Neurology and Neurosurgery (NHNN) and the Wellington Hospital (WH) were reviewed.Outcome measuresFrankel grade.MethodsPatients who developed SEH and underwent evacuation of the hematoma were identified. Two controls per case were selected. Each control had undergone a procedure with similar complexity, at the same section of the spine, at the same hospital, and under the same surgeon within 6 months of the initial operation.ResultsA total of 4,568 open spinal operations were performed at NHNN and WH. After spinal surgery, 0.22% of patients developed symptomatic SEH. Alcohol greater than 10 units a week (p=.031), previous spinal surgery (p=.007), and multilevel procedures (p=.002) were shown to be risk factors. Initial symptoms of SEH presented after a median time of 2.7 hours (interquartile range [IQR], 1.1–126.1). Patients who had evacuation surgery within 6 hours of the onset of initial symptoms improved a median of 2 (IQR, 1.0–3.0) Frankel grades, and those who had surgery more than 6 hours after the onset of symptoms improved 1.0 (IQR, 0.0–1.5) Frankel grade, p=.379.ConclusionsSymptomatic postoperative SEH is rare, occurring in 0.22% of cases. Alcohol consumption greater than 10 units a week, multilevel procedure, and previous spinal surgery were identified as risk factors for developing SEH. Spinal epidural hematoma often presents early in the postoperative period, highlighting the importance of close patient monitoring within the first 4 hours after surgery. This study suggests that earlier surgical intervention may result in greater neurological recovery.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Spine Journal - Volume 13, Issue 2, February 2013, Pages 134–140
نویسندگان
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