Spinal Subdural Hematoma: Rare Complication of Spinal Decompression Surgery

World Neurosurg. 2022 Feb:158:114-117. doi: 10.1016/j.wneu.2021.10.141. Epub 2021 Oct 26.

Abstract

Objective: Spinal subdural hematoma (SSH) is a rare and infrequently reported complication of hemilaminectomy, laminectomy, and other spinal decompression surgeries. In this review, we aim to analyze the available literature for reported cases of SSH to better identify risk factors and presenting symptoms, as well as highlight the importance in prompt investigation and management of SSH to prevent long-term morbidity and chronic neurologic deficit.

Methods: A review of the medical literature was undertaken using search terms hemilaminectomy OR laminectomy AND spinal subdural haematoma. All identified reports were screened for language, adult population, and human studies. Report abstracts were screened for relevance to question, with SSH occurring postoperatively following hemilaminectomy or laminectomy included. Four reports were included in the review.

Conclusions: SSH is a rare, emergency condition with neurologic deficit that can present as recurrent back pain and acute cauda equina postoperatively following hemilaminectomy and laminectomy procedures. Vigilance, early investigation, and surgical evacuation is important in preventing short- and long-term morbidity. Further collation of data and analysis is required to better identify patients at high risk for developing SSH postoperatively.

Keywords: Hemilaminectomy; Laminectomy; Postoperative complication; Spinal subdural hematoma.

Publication types

  • Review

MeSH terms

  • Adult
  • Decompression, Surgical / adverse effects
  • Hematoma, Subdural, Spinal* / diagnostic imaging
  • Hematoma, Subdural, Spinal* / etiology
  • Hematoma, Subdural, Spinal* / surgery
  • Humans
  • Laminectomy / adverse effects
  • Laminectomy / methods
  • Magnetic Resonance Imaging