Risk factors for spinal epidural hematoma after spinal surgery
Risk factors for spinal epidural hematoma after spinal surgery
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DOI：
10.1097/00007632-200208010-00016
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发表时间：
2002-08-01
期刊：
影响因子：
3
通讯作者：
Herkowitz, H
中科院分区：
文献类型：
--
作者：
Kou, J;Fischgrund, J;Herkowitz, H
研究设计.一项病例对照回顾性分析，对术后发生脊髓硬膜外血肿的患者与未发生该并发症的患者进行比较。确定脊柱手术后发生硬膜外血肿的危险因素。背景资料概要。脊柱手术后的神经功能恶化是一种罕见但毁灭性的并发症。对于术后出现新的神经功能缺损的病人，应怀疑有硬膜外血肿。使患者易于发生术后硬膜外血肿的危险因素尚未确定。回顾性分析了10年内在一家机构接受脊柱手术的患者。确定了12例术后表现出神经功能恶化并因硬膜外血肿需要手术减压的患者。所有病例均涉及腰椎椎板切除术。共有404例连续接受腰椎减压术且未发生硬膜外血肿的患者组成对照组。采用Logistic回归分析比较两组患者术后硬膜外血肿发生的危险因素。多节段手术（P=0.037）和术前凝血功能障碍（P
Study Design. A case-control retrospective analysis comparing patients who developed a postoperative spinal epidural hematoma with patients who did not develop this complication.Objectives. To identify risk factors for the development of an epidural hematoma following spinal surgery.Summary of Background Data. Neurologic deterioration following spinal surgery is a rare but devastating complication. Epidural hematomas should be suspected in the patient who demonstrates a new postoperative neurologic deficit. The risk factors that predispose a patient to a postoperative spinal epidural hematoma have not been identified.Methods. Patients who underwent spinal surgery at a single institution over a 10 year period were retrospectively reviewed. Twelve patients who demonstrated neurologic deterioration after surgery and required surgical decompression because of an epidural hematoma were identified. All cases involved lumber laminectomies. A total of 404 consecutive patients that underwent lumbar decompression and did not develop an epidural hematoma formed the control group. Factors postulated to increase the risk of postoperative spinal epidural hematoma were compare between the two groups using logistic regression.Results. Multilevel procedures (P=0.037) and the presence of a preoperative coagulopathy (P