Abstract

ROCHA, Rui et al. Hematoma epidural com paraplegia flácida: complicação de pós-operatório imediato. Rev. Port. Ortop. Traum. [online]. 2014, vol.22, n.1, pp.94-101. ISSN 1646-2122.

Objective: The authors want to share the experience of this major surgical complication, and conduct a brief review on the topic addressing references in the literature on the incidence and risk factors associated with this disease. Description: The authors present as clinical case a male patient aged 70 years old with prostate cancer who underwent laminectomy of L2 and postero-lateral instrumented fusion of L1-L3 due to neurogenic claudication from L2 metastasis. In the immediate postoperative settled a progressive neurologic deficit with flaccid paraplegia and need for reoperation for drainage of epidural hematoma confirmed by MRI. The patient recovered neurologically after draining the hematoma having resumed their daily activities. Comments: Most epidural hematomas in postoperative pathology of spinal surgery are asymptomatic. The need for surgical drainage boils down to 0.1 to 3% of the hematomas diagnosed, being emergent after the onset of neurological deficits. Physicians must be aware of the risk factors for the development of symptomatic epidural hematoma in the immediate postoperative period to forecast its possibility.

Keywords : Epidural space; laminectomy; spinal epidural hematoma; paraplegia; surgical decompression; spinal fusion.

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