ArticleBioMed research international2020
Delayed Onset Postoperative Spinal Epidural Hematoma after Lumbar Spinal Surgery: Incidence, Risk Factors, and Clinical Outcomes.
Article in BioMed research international, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 18 citations in OpenAlex.
- Interpreting acute postoperative MRI after lumbar spinal fusion: a practical framework for clinical decision-making.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Review
- Impact of Paraspinal Muscle Characteristics on the Risk of Symptomatic Epidural Hematoma Following Transforaminal Lumbar Interbody Fusion.Global spine journal · 2026Article
- Lumbar epidural haematoma after acupuncture: a case report and review of the literature.Journal of medical case reports · 2026Review
- Low cerebrospinal fluid pressure predisposes to postoperative epidural hematoma following lumbar decompression: a potentially modifiable physiological risk factor.BMC musculoskeletal disorders · 2026Article
- Interpretable prediction of prolonged length of stay for patients undergoing lumbar disc herniation surgery based on machine learning and SHAP.BMC health services research · 2026Article
- Delayed Postoperative Spinal Epidural Hematoma After Thoracic OPLL Surgery: A Case Report and Literature Review.Clinical case reports · 2026Article
- Symptomatic adjacent-segment epidural hematoma after UNSES for L4/5 lumbar disc herniation: a case report and narrative literature review.Frontiers in surgery · 2026Article
- Delayed postoperative spinal epidural hematoma after one-hole split endoscope discectomy: a case report and literature review.Frontiers in surgery · 2026Article
- Nonsurgical segment "spreading-type" symptomatic epidural hematoma formation after lumbar fusion surgery: A case report and literature review.The Journal of international medical research · 2025Review
- Post-operative Microdiscectomy Complicated by Lumbar Epidural Hematoma with Cauda equina Syndrome Following Dual Viral Infection: A Rare Case Report and Its Management.Journal of orthopaedic case reports · 2025Article
- Optimal timing for decompression in post-operative epidural hematoma: a retrospective analysis and treatment flowchart.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- The safety and effectiveness of transforaminal lumbar interbody fusion (TLIF) surgery for the treatment of lumbar disc herniation.Frontiers in surgery · 2025Article
- [Incidence and risk factors of postoperative epidural hematoma following anterior cervical spine surgery].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2024Article
- Paraplegia Caused by a Large Spinal Epidural Hematoma 12 Days After Thoracic Decompression and Fusion.Cureus · 2024Article
- Consensus statement by the Belgian Society of Neurosurgery and literature review on the diagnosis and management of postoperative spinal epidural hematoma.Brain & spine · 2024Review
- Article
- First report of lumbar spinal epidural hematoma after pelvic ring fracture.Spinal cord series and cases · 2023Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPosterior spinal epidural haematoma (PSEH) often develops within 24 hours after surgery. On rare occasions, PSEH occurs after 3 days and up to two weeks and is classified as delayed-onset PSEH. Due to its rarity, previous studies have only described the clinical features, whereas risk factors have not been assessed.
methodsPatients who developed PSEH requiring haematoma evacuation between December 2013 and January 2020 were included and divided into the early-onset (group A) and delayed-onset (group B) groups based on the time of symptom onset (>72 hours). For each PSEH patient, 3 controls (group C) who did not develop PSEH in the same period were randomly selected. Clinical features were compared among the three groups, and multiple logistic regression analysis was performed to identify the risk factors for groups A and B.
resultsThirty-two patients (0.35%) were identified as having early-onset PSEH (occurring at 10.68 ± 11.5 h), and 15 (0.16%) patients had delayed-onset PSEH (occurring at 130.60 ± 61.78 h). When comparing groups A and B, group A showed a higher rate of multilevel procedures, lower drainage, lower APTT, and higher JOA score at discharge. Multiple logistic regression analysis identified multilevel procedures (OR: 5.62, 95% CI: 1.84-17.25), postoperative systolic blood pressure (SBP) (OR: 1.10, 95% CI: 1.06-1.15), and abnormal coagulation (OR: 5.68, 95% CI: 1.74-18.52) as independent risk factors for group A, whereas postoperative SBP (OR: 1.10, 95% CI: 1.04-1.16) and previous spinal surgery (OR: 4.74, 95% CI: 1.09-20.70) at the same level were risk factors for group B.
conclusionsOur study revealed that the overall incidence of delayed-onset PSEH was 0.16% in posterior lumbar spinal surgery and that its risk was different from that of early-onset PSEH. If patients with such risk factors develop neurological deficits 3 days after initial surgery, surgeons should be aware of the possibility of delayed-onset PSEH.
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