Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2011;7(1):79-83.
Published online June 30, 2011.
Improvement of the Motor Function after Surgical Decompression for Spinal Epidural Hematomas
Jin Gyeong Ha, Jin Hoon Park, Sang Ryong Jeon, Young Hyun Cho, Chang Jin Kim
Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Abstract
Objective
Spinal epidural hematoma (EDH) is a relatively rare disease requiring urgent management. We evaluated here the clinical characteristics, magnetic resonance imaging (MRI) findings and functional outcomes after surgical decompression in 14 patients with spinal EDH. Method: A retrospective study was conducted on fourteen patients who were treated surgically for spinal EDH between 1996 and 2010. The clinical characteristics of each patient were reviewed and MRI findings were analyzed for spinal cord compression, extent and chronological stage of EDH and presence of vascular lesions. Pre- and postoperative motor power together with ambulatory function by functional independence measure (FIM) was analyzed comparatively.
Results
Fourteen patients consisted of 8 men and 6 women, with mean age 54 years (range ; 14-82 years). Mean follow-up period was 17 months (range ; 3-48 months). Four patients had a history of trauma. All patients harbored motor deficits : motor power grade I in seven patients, grade II in three, grade III in three and grade IV in one. The mean preoperative FIM was 2.1. Surgery was carried out within 48 hours from symptom onset in most patients. At last follow-up, the mean FIM was 4.7. The motor power and FIM improved in ten (71.4%) and twelve (85.7%) patients, respectively compared to the preoperative status.
Conclusion
As the management of spinal EDH associated with acute motor deficits, early diagnosis and urgent surgical decompression is recommended to improve the motor power together with ambulatory function.
Key Words: Spinal epidural hematoma, Magnetic resonance imaging, Surgical outcome, Ambulatory function.


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