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Spinal subarachnoid hematoma with hyperextension lumbar fracture in diffuse idiopathic skeletal hyperostosis: a case report.
Spine (Phila Pa 1976). 2009 Aug 15; 34(18):E673-6.S

Abstract

STUDY DESIGN

A case report of a spinal subarachnoid hematoma (SSAH) associated with hyperextension fractures complicating diffuse idiopathic skeletal hyperostosis (DISH).

OBJECTIVE

To report the first case of a SSAH complicating spinal fracture in DISH.

SUMMARY OF BACKGROUND DATA

A SSAH is very rare condition. And there had been several reports on spinal fractures in DISH through fused spinal segments, but no report related with SSAH associated with spinal fracture in DISH patient.

METHODS

A 78-year-old female patient was admitted for pain in the back and lower limbs and paraparesis after being fall on her back. On simple radiographs, DISH with anterior cortical bone deficit and increased height were presented at the level of L1. MR and Myelography computed tomography images revealed an extension type of fracture with an irregular shaped subarachnoid hematoma within the dura. Differential diagnosis from infection or tumorous condition was required.

RESULTS

Durotomy and 1 to 2 laminectomy was performed to improve neurologic symptoms. The posterior yellow ligament was seen partially ossified and adhered to dura without dura tear. The hematoma was found adherent to the nerve roots of the cauda equina and pia mater. After posterior segmental screw instrumentation and fusion from T10 to L3, anterior interbody fusion was performed with extrapleural approach after dissected the 11th rib, using L1 corpectomy and titanium mesh cages. There was no evidence of infection or tumor. After surgery, motor and sensory function of the lower limbs improved remarkably with solid bony union.

CONCLUSION

The first case of a SSAH complicating spinal fracture in DISH is presented. The patient was successfully treated with a staged operation including posterior decompression with fusion and anterior interbody fusion.

Authors+Show Affiliations

Department of Orthopedic Surgery, Spine Center, East West Neomedical Center, Kyung Hee University School of Medicine, 149 Sangil-dong, Kangdong-gu, Seoul, Korea. shl6@khu.ac.kr

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19680094

Citation

Lee, Sang-Hun. "Spinal Subarachnoid Hematoma With Hyperextension Lumbar Fracture in Diffuse Idiopathic Skeletal Hyperostosis: a Case Report." Spine, vol. 34, no. 18, 2009, pp. E673-6.
Lee SH. Spinal subarachnoid hematoma with hyperextension lumbar fracture in diffuse idiopathic skeletal hyperostosis: a case report. Spine (Phila Pa 1976). 2009;34(18):E673-6.
Lee, S. H. (2009). Spinal subarachnoid hematoma with hyperextension lumbar fracture in diffuse idiopathic skeletal hyperostosis: a case report. Spine, 34(18), E673-6. https://doi.org/10.1097/BRS.0b013e3181b0b3ac
Lee SH. Spinal Subarachnoid Hematoma With Hyperextension Lumbar Fracture in Diffuse Idiopathic Skeletal Hyperostosis: a Case Report. Spine (Phila Pa 1976). 2009 Aug 15;34(18):E673-6. PubMed PMID: 19680094.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spinal subarachnoid hematoma with hyperextension lumbar fracture in diffuse idiopathic skeletal hyperostosis: a case report. A1 - Lee,Sang-Hun, PY - 2009/8/15/entrez PY - 2009/8/15/pubmed PY - 2010/1/13/medline SP - E673 EP - 6 JF - Spine JO - Spine (Phila Pa 1976) VL - 34 IS - 18 N2 - STUDY DESIGN: A case report of a spinal subarachnoid hematoma (SSAH) associated with hyperextension fractures complicating diffuse idiopathic skeletal hyperostosis (DISH). OBJECTIVE: To report the first case of a SSAH complicating spinal fracture in DISH. SUMMARY OF BACKGROUND DATA: A SSAH is very rare condition. And there had been several reports on spinal fractures in DISH through fused spinal segments, but no report related with SSAH associated with spinal fracture in DISH patient. METHODS: A 78-year-old female patient was admitted for pain in the back and lower limbs and paraparesis after being fall on her back. On simple radiographs, DISH with anterior cortical bone deficit and increased height were presented at the level of L1. MR and Myelography computed tomography images revealed an extension type of fracture with an irregular shaped subarachnoid hematoma within the dura. Differential diagnosis from infection or tumorous condition was required. RESULTS: Durotomy and 1 to 2 laminectomy was performed to improve neurologic symptoms. The posterior yellow ligament was seen partially ossified and adhered to dura without dura tear. The hematoma was found adherent to the nerve roots of the cauda equina and pia mater. After posterior segmental screw instrumentation and fusion from T10 to L3, anterior interbody fusion was performed with extrapleural approach after dissected the 11th rib, using L1 corpectomy and titanium mesh cages. There was no evidence of infection or tumor. After surgery, motor and sensory function of the lower limbs improved remarkably with solid bony union. CONCLUSION: The first case of a SSAH complicating spinal fracture in DISH is presented. The patient was successfully treated with a staged operation including posterior decompression with fusion and anterior interbody fusion. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/19680094/Spinal_subarachnoid_hematoma_with_hyperextension_lumbar_fracture_in_diffuse_idiopathic_skeletal_hyperostosis:_a_case_report_ L2 - https://doi.org/10.1097/BRS.0b013e3181b0b3ac DB - PRIME DP - Unbound Medicine ER -