Journal of Medical Sciences (Jan 2023)

Conservative management for spontaneous lumbar facet joint hemarthrosis in severe hemophilia a: A rare case report

  • Chia-Ying Lai,
  • Yeu-Chin Chen,
  • Tsung-Ying Li

DOI
https://doi.org/10.4103/jmedsci.jmedsci_281_21
Journal volume & issue
Vol. 43, no. 1
pp. 37 – 39

Abstract

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Spontaneous lumbar facet joint bleeding is rarely observed in patients with hemophilia. Since it is categorized as a spinal epidural hematoma, surgery is the main treatment. Conservative treatment was successful in patients with minor or absent neurological deficits. We aimed to present the case of a patient with severe hemophilia who suffered from acute sciatica caused by lumbar facet joint hematoma. Nonsurgical treatment using a multidimensional approach was provided. The hemarthrosis is completely resolved. The patient recovered from clinical neurological symptoms without recurrence throughout the 4-year follow-up period. Spontaneous lumbar facet joint hemarthrosis in patients with severe hemophilia who present with mild neurological symptoms can be conservatively treated if the hemarthrosis is recognized early. Moreover, a multidisciplinary team approach is paramount in achieving good patient outcomes.

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