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Epidural hematoma following spinal cord stimulator implant
© Springer-Verlag London Ltd 2010
- Received: 23 December 2009
- Accepted: 25 February 2010
- Published: 18 May 2010
- Spinal Cord
- Abnormal Signal
- Spinal Cord Stimulator
- Epidural Hematoma
- Hematoma Evacuation
A 50-year-old male with chronic low-back pain presented to the ED with mid-back pain, numbness, paresthesia and weakness in both legs. These symptoms were preceded by a sudden onset of paralysis below the waistline without loss of bowel or bladder control, which occurred during the surgical placement of a neurostimulator. The device was immediately removed, and the patient’s paralysis partially resolved. He transitioned into his current symptom complex. He was immediately transferred to the ED for evaluation. Physical exam showed stable vital signs, tenderness to palpation in the spine, decreased sensation T12 and below, 4/5 strength in the lower extremities, and 2+ distal pulses, intact peri-anal sensation but decreased rectal tone. MRIs of the thoracic and lumbar spines were obtained, revealing an epidural hematoma from T8–L2.
The patient underwent an emergent hematoma evacuation and concurrent T6–L1 laminectomy with in situ fusion. He tolerated the procedure well and was discharged 6 days later to a rehabilitation facility with some improvement to his lower extremity strength, sensation and bladder and rectal control.
Epidural hematoma formation after placement of an epidural spinal cord electrode is an extremely rare and serious complication. Our PubMed search only yielded two similar cases in the published literature, neither of which was in English [1, 2].
- Franzini A, Ferroli P, Marras C, Broggi G (2005) Huge epidural hematoma after surgery for spinal cord stimulation. Acta Neurochir (Wien) 147(5):565–567View ArticleGoogle Scholar
- Santiago FM, Santiago J, Prieto M et al (2005) Dorsal epidural hematoma after implantation of a dorsal nerve stimulator. Rev Esp Anestesiol Reanim 52(7):440–441PubMedGoogle Scholar