Asian Spine J.  2007 Jun;1(1):57-60. 10.4184/asj.2007.1.1.57.

Epidural Hematoma Presenting with Severe Neck Pain without Neurological Deficit - A Late Complication of Posterior Cervical Spine Surgery: Presentation of Three Unusual Cases

• Khan MH
• Lee JY
• Donaldson
• Kang JD

• KMID: 1908151
• DOI: http://doi.org/10.4184/asj.2007.1.1.57

Abstract

Postoperative epidural hematoma (EDH) usually present with neurological deficit. Massive EDH presenting with only severe pain without neurological deficit are rare. Atypical presentations of postoperative EDHs may lead to delayed diagnosis and treatment. We present three such cases after posterior cervical spine surgery. Three patients presented with severe neck pain and spasms without motor deficits several days after posterior cervical decompressive procedures. Imaging studies identified compressive EDHs at the surgical site with severe compression of the spinal cord. All were treated with emergent decompression, with resulting improvement of symptoms and pain relief without further neurological sequelae. In conclusion, postoperative EDHs after posterior cervical spine surgery may result in minimal neurological deficit. Our report reminds surgeons to keep this possibility in mind when patients complain of unusually severe neck pain and spasms after posterior cervical spine surgery.

Keyword

Cervical spine; Epidural hematoma; Postoperative complication

MeSH Terms

Decompression
Delayed Diagnosis
Hematoma*
Humans
Neck Pain*
Neck*
Postoperative Complications
Spasm
Spinal Cord
Spine*