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Spinal Subdural Hematoma Journal | Open Access Journals
Journal of Spine

Journal of Spine

ISSN: 2165-7939

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Spinal Subdural Hematoma Journal

Traumatic spinal subdural hematomas (SDH) are a rarely reported condition that can cause permanent neurological deficit. Evidence is lacking to guide management decisions. At present the illustrative case of conservatively managed traumatic spinal SDH, and systematically examine the reports of traumatic spinal SDH for predictive variables of a favorable outcome. A systematic review was carried out including the demographic, clinical and radiographic variables extracted from the case studies. The t-tests, the Pearson chi-square and the exact Fischer test were used to determine the differences in results between the groups. Fifty-eight reported cases, including our illustrative case, met the inclusion criteria. The majority of patients were men (66.7%) with an average age of 41.3 ± 24.7 years. Most of the trauma was minor (62.1%), those who presented with direct spinal trauma were more likely to have a poor outcome. Common presentation symptoms included back pain (N = 45, 77.6%), radiculopathy (N = 33, 56.9%) and subjective weakness (N = 39, 67.2%). A neurological deficit was present in 51.7% of the patients and in all those whose outcome was poor (p <0.001). A favorable result was reported in 47 patients (81.0%) and the concomitant cranial SDH was statistically more frequent in this group (61.7%, p = 0.002). In trauma patients with back pain, weakness or neurological deficits, vertebral SDH must be taken into account in the differential. Reinsurance and conservative management can often be a first-line treatment, and the presence of cranial SDH may suggest a favorable outcome. Neurological deficit and compression of the cord on presentation are associated with poor results and justify urgent surgical treatment.

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Citations: 2022

Journal of Spine received 2022 citations as per Google Scholar report

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