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First report of lumbar spinal epidural hematoma after pelvic ring fracture

Spinal Cord Series and Cases volume 9, Article number: 30 (2023) Cite this article

Subjects

Abstract

Introduction

Spinal epidural hematoma is a rare condition that most commonly occurs as a complication of spinal surgery. For patients with neurological deficits, surgical decompression can generally provide good outcome.

Case

A 56-year-old, otherwise healthy, patient was admitted to the orthopedic emergency department with a pelvic ring fracture. Over the course of 4 days, a lumbar spinal epidural hematoma developed, with the patient complaining of pain radiating to the S1 dermatome and saddle paresthesia. The hematoma was surgically decompressed, and the patient had a complete recovery.

Discussion

To our knowledge, this is the first report of a spinal epidural hematoma after pelvic ring fracture. The etiology of spinal epidural hematoma is diverse, but it is most frequently observed after spinal surgery. It has rarely been observed after lumbar spinal fractures, nearly exclusively in patients with ankylosing spondylitis.

Conclusion

Pelvic ring fracture might result in spinal epidural hematoma. The presence of neurological deficits after such fractures is an indication for lumbosacral MRI. Surgical decompression will generally resolve the neurological symptoms.

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Acknowledgements

Dr. Aliabadi, the lead clinical investigator, is the first to describe such a case.

Author information

Authors and Affiliations

  1. BKH St. Johann in Tirol, Abteilung für Orthopädie und Traumatologie, Bahnhofstraße 14, 6380 St. Johann in Tirol, Österreich, Austria

    Moritz Wagner, Tino Riegger, Alexander Brunner & Hedye Aliabadi

  2. Krems Donauuniversität, Abteilung für Orthopädie und Traumatologie, Dr.-Karl-Dorrek-Straße 30, 3500, Krems an der Donau, Austria

    Dietmar Dammerer

  3. ARCUS Sportklinik, Rastatter Str. 17-19, 75179, Pforzheim, Germany

    Benjamin Ulmar

Authors
  1. Moritz Wagner
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  2. Tino Riegger
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  3. Alexander Brunner
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  4. Dietmar Dammerer
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  5. Benjamin Ulmar
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  6. Hedye Aliabadi
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Contributions

MW: Conceptualization, Methodology, Writing; TR: Supervision; AB; Resources, Validation; DD: Investigation, Methodology; BU: Supervision; HA: Visualization, Supervision, Investigation.

Corresponding author

Correspondence to Moritz Wagner.

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The authors declare no competing interests.

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Wagner, M., Riegger, T., Brunner, A. et al. First report of lumbar spinal epidural hematoma after pelvic ring fracture. Spinal Cord Ser Cases 9, 30 (2023). https://doi.org/10.1038/s41394-023-00589-z

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