| ObjectiveTo evaluate the etiology, pathogenesis, clinical manifestation, imaging features, treatments and factors related to prognosis of acute spinal hematoma.MethodsThe clinical data of38patients with acute spinal hematoma treated in our hospital from2011till now were analyzed retrospectively. Duration of follow-up was6(?). The factors influencing the prognosis were analyzed.ResultsAcute epidural hematomas were much more common than others:epidural in29cases, subdural in5cases, subarachnoid in1case and intramedullary in3cases. Hematomas were frequently located in the cervical and thoracic spine, and dorsal to the spine cord, especially in epidural hematoma. Most patients have unknown reasons.23patients underwent emergency surgery because of rapidly progress in neurological deficits.9patients underwent conservative treatment. After6months follow up,50%of38cases were completely recovery. The patients with complete recovery were29.41%and53.85%in complete paraplegia group and incomplete paraplegia group. In emergency surgery group, the time from onset to complete paraplegia in patients with complete recovery (10.9±3.6hours) was longer than patients with incomplete recovery (2.2±1.2hours)(P<0.05). The time from onset to surgery in patients with complete recovery(13.4±1.7hours) was shorter than patients with incomplete recovery (22.0±3.8hours)(P<0.05).ConclusionThe causes of acute spinal hematoma include variable reasons even with unknown etiology, and usually manifests with a sudden onset of pain and paralysis. The early diagnosis mainly depends on MRI. Patients presenting with severe neurologic dysfunction or who show signs of progressive deficit should choose immediate surgical decompression via laminectomy. Conservative approaches were reserved for those with minimal neurological manifestations and bleeding tendency. Emergency surgery may lead to complete recovery of neurological deficits. The speed of neurological progress and interval of onset to surgery related to recovery. |
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