Journal List > J Korean Orthop Assoc > v.54(2) > 1121868

Seok-Ha, Seung-Pyo, Sung-Ha, and Joo-Young: Cauda Equine Syndrome Induced by Spinal Epidural Hematoma due to a Low-Energy Osteoporotic Vertebral Fracture

Abstract

Spinal epidural hematoma (SEH) can occur naturally or traumatically and is most common in patients with an underlying disease of the vascular structure or coagulation disorder. Most SEHs occur naturally for no apparent reason, and epidural hematoma caused by trauma is less common, comprising 1.0%–1.7% of total spinal injuries. Few reports of SEH induced cauda equine syndrome resulting from low-energy injury caused by osteoporotic vertebral compression fractures are available. The authors experienced a case of delayed SEH after hemorrhage due to a low-energy injury in an elderly patient. No cases in Korea have been reported; therefore, this case is reported with a review of the relevant literature.

References

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Figure 1.
Initial lateral Radiography (A), T1 weighted sagittal magnetic resonance image (B), and T2 weighted fat suppression sagittal magnetic resonance image (C) demonstrating a recent compression fracture of the L5 vertebral body compression rate 30.2%. T2 weighted axial magnetic resonance image through the L5 vertebra (D) showing no visible epidural hematoma.
jkoa-54-187f1.tif
Figure 2.
Preoperation magnetic resonance imaging studies demonstrating epidural hematoma. (A) Gadolinium enhanced T1 weighted sagittal magnetic resonance image shows epidural lesion (hematoma) (arrow) showing intermediate high signal, compressing dural sac. (B) Gadolinium enhanced T1 weighted axial magnetic resonance image shows that the left posterolateral dural sac (arrow) is a compressed epidural lesion at L5-S1.
jkoa-54-187f2.tif
Figure 3.
Intraoperative photograph shows that the left S1 root was compressed due to an epidural hematoma.
jkoa-54-187f3.tif
Figure 4.
One months later, gadolinium enhanced T1 weighted sagittal magnetic resonance image (A) and gadolinium enhanced T1 weighted axial magnetic resonance image (B) showed no more visible nonenhanced left posterolateral epidural lesion at L5-S1.
jkoa-54-187f4.tif
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