Interdisciplinary Neurosurgery (Sep 2021)
A retrospective analysis of 30 patients with spontaneous spinal epidural hematoma
Abstract
Background: Spontaneous spinal epidural hematoma (SSEH) is a rare disease. Despite numerous case reports, the clinical characteristics and prognosis of patients with SSEH in the contemporary aging population are unknown. The purpose of this study was to clarify the clinical characteristics, prognostic factors, and optimal management of SSEH. Methods: We retrospectively reviewed and analyzed patients with SSEH who were admitted to Shinshu University Hospital between July 2009 and October 2019. The modified Rankin Scale (mRS) was used to measure the degree of disability in patients with SSEH at discharge as a functional outcome and patients were classified accordingly. Clinical variables of patients with good (mRS 0–2) and poor (mRS > 2) outcomes were compared. Results: We identified 30 patients with SSEH (17 men and 13 women) aged 36–89 years (median age, 67 years). Twelve patients had hypertension. Surgical treatment was performed in 11 patients. The number of patients who had taken anticoagulants was higher in the poor outcome group than in the good outcome group (p = 0.01). The poor outcome group were older (p = 0.048), had a higher operation rate (p = 0.04) and longer lengths of hospitalization (p < 0.001) than the good outcome group. Anticoagulants were the only factor associated with poor outcome in the univariate analysis (odds ratio, 16 [1.45–176], p = 0.02). Conclusions: SSEH patients who had been taking anticoagulants had a worse functional outcome. Physicians should consider that SSEH patients who have been taking anticoagulants require timely management, including surgery.
