J Korean Soc Spine Surg.  2017 Mar;24(1):44-48. 10.4184/jkss.2017.24.1.44.

Acute Epidural Hematoma Following Cervical Spinal Fracture in a Patient with Ankylosing Spondylitis

• Kim SB
• Heo YM
• Oh BH
• Kim TG
• Jung YS

• KMID: 2402842
• DOI: http://doi.org/10.4184/jkss.2017.24.1.44

Abstract

STUDY DESIGN: Case report.
OBJECTIVES
To report a case of epidural hematoma following cervical spinal fracture in a patient with ankylosing spondylitis. SUMMARY OF LITERATURE REVIEW: An early surgical intervention for acute epidural hematoma following cervical spinal fracture led to improvements in the patient's neurological deficits.
MATERIALS AND METHODS
A 76-year-old male with ankylosing spondylitis presented with neck pain and motor weakness of both upper and lower extremities after falling. He sustained fractures of the C7 body and the spinous processes of C5 and C6. Magnetic resonance imaging showed an extensive epidural hematoma from C7 to T5. The authors performed decompression from C6 to T2, and posterior instrumentation and fusion from C4 to T3.
RESULTS
An urgent surgical intervention was performed, and a good result was obtained.
CONCLUSIONS
The authors describe an early surgical intervention in a case of acute epidural hematoma following cervical spinal fracture in a patient with ankylosing spondylitis.

Keyword

Ankylosing spondylitis; Epidural hematoma; Cervical spinal fracture

MeSH Terms

Accidental Falls
Aged
Decompression
Hematoma*
Humans
Lower Extremity
Magnetic Resonance Imaging
Male
Neck Pain
Spinal Fractures*
Spondylitis, Ankylosing*

Figure

• 

  Fig. 1. Initial radiologic findings taken 2 hours after the trauma. (A) A lateral X-ray shows the ankylosed cervical spine. (B) Computed tomography shows fracture of the C7 body. (C, D) On magnetic resonance imaging, a T2-weighted sagittal view and a Dixon view delineate a posterior epidural lesion with an iso to high signal from C7 to T5, corresponding to acute hematoma.

• 

  Fig. 2. Postoperative radiologic findings. (A) A plain radiograph shows in situ posterior fixation from C4 to T3. (B) Cervical spine computed tomography shows adequate posterior decompression from C6 to T2.

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