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Abstract
Objectives
To investigate the outcomes of recapping laminoplasty for the treatment of atraumatic spinal interdural hematoma.
Summary of Literature Review
There are several causes for a spinal hematoma. The occurrence of spinal hematoma is rare; in particular, the ones arising atraumaticaly are considered extremely rare.
Materials and Methods
We studied a 33 year old male patient without any known risk factor. Magnetic resonance image has revealed an intraspinal epidural cyst compressing on the spinal nerve. After performing recapping laminoplasty, followed by partial excision of dura mater and resection of hematoma, we were able to observe another layer of dura mater, confirming the location of hematoma within two epidural layers, i.e., an interdural hematoma.
Results
Performing recapping laminoplasty is a more effective and less invasive procedure for removing cyst than conventionally used laminectomy. Patients were found to have synostosis after three months postop, and they have exhibited neither lumbosacral pain nor lower limb motor weakness after six months followup. There were no recurrences or complications reported on our study.
REFERENCES
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2. Post MJ, Becerra JL, Madsen PW, et al. Acute spinal subdural hematoma: MR and CT findings with pathologic correlates. Am J Neuroradiol. 1994; 15:1895–905.
3. Haines DZ, Harkey HL, Al‐Mefty O. The “subdural” space: a new look at an outdated concept. Neurosurgery. 1993; 32:111–20.
4. Blomberg RG. The lumbar subdural extraarachnoid space of humans: an anatomical study using spinaloscopy in au-topsy cases. Anesth Analg. 1987; 66:177–80.
5. Lö vblad KO, Baumgartner RW, Zambaz BD, Remonda L, Ozdoba C, Schroth G. Nontraumatic spinal epidural hematomas. MR features. Acta Radiol. 1997; 38:8–13.
Fig. 2.
(A, B) Intraoperative Gross photo. The incision was made on outer layer of the dura. We observed two layers of dura separated by bloody contents (White arrow being outer interdural layer, asterisk (*) pointing to hematoma, black arrow indicating inner interdural layer subsequent to resection of hematoma) The supraspinous, interspinous ligaments were intact.
Fig. 3.
Postoperative CT scan. We have used nails in order to fix the posterior structures which had been relocated. Two areas, the first being between superior and inferior spinous processes and the second being adjacent to isthmus, were internally fixated using nails. Both places were undergone osteotomy prior to fixation.
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