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Acute Lumbar Spinal Subdural Hematoma Inducing Paraplegia After Lumbar Spinal Manipulation: Case Report and Literature Review.
World Neurosurg. 2019 Aug; 128:182-185.WN

Abstract

BACKGROUND

Traumatic spinal subdural hematoma is an extremely rare occurrence that requires urgent investigation and most often prompt intervention. To our knowledge, this is the first reported case related to a spinal manipulative therapy.

CASE DESCRIPTION

This report describes a case of traumatic lumbar subdural hematoma after a spinal manipulative therapy without any predisposing factor. A 23-year-old man was admitted to the emergency department for partial cauda equina syndrome after a spinal manipulation performed by a physiotherapist. Magnetic resonance imaging showed an acute spinal subdural hematoma at L2-L3 level with cauda equina compression. The patient underwent an emergency L2 laminectomy with evacuation of the hematoma. He recovered completely his neurologic functions after 1 week.

CONCLUSION

Practitioners of spinal manipulations should be aware of spinal subdural hematoma as a possible complication. A rapid diagnosis with magnetic resonance imaging is mandatory, and emergency surgical decompression is usually the optimal treatment for spinal subdural hematomas with severe neurologic deficit.

Authors+Show Affiliations

Department of Neurosurgery, University Hospital Center of Marrakech, FMPM, Cadi Ayyad University of Marrakech, Marrakech, Morocco. Electronic address: zakariae.benyaich@gmail.com.Department of Neurosurgery, University Hospital Center of Marrakech, FMPM, Cadi Ayyad University of Marrakech, Marrakech, Morocco.Department of Neurosurgery, University Hospital Center of Marrakech, FMPM, Cadi Ayyad University of Marrakech, Marrakech, Morocco.Department of Neurosurgery, University Hospital Center of Marrakech, FMPM, Cadi Ayyad University of Marrakech, Marrakech, Morocco.Department of Neurosurgery, University Hospital Center of Marrakech, FMPM, Cadi Ayyad University of Marrakech, Marrakech, Morocco.Department of Neurosurgery, University Hospital Center of Marrakech, FMPM, Cadi Ayyad University of Marrakech, Marrakech, Morocco.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

31078801

Citation

Benyaich, Zakariae, et al. "Acute Lumbar Spinal Subdural Hematoma Inducing Paraplegia After Lumbar Spinal Manipulation: Case Report and Literature Review." World Neurosurgery, vol. 128, 2019, pp. 182-185.
Benyaich Z, Laghmari M, Lmejjati M, et al. Acute Lumbar Spinal Subdural Hematoma Inducing Paraplegia After Lumbar Spinal Manipulation: Case Report and Literature Review. World Neurosurg. 2019;128:182-185.
Benyaich, Z., Laghmari, M., Lmejjati, M., Aniba, K., Ghannane, H., & Ait Benali, S. (2019). Acute Lumbar Spinal Subdural Hematoma Inducing Paraplegia After Lumbar Spinal Manipulation: Case Report and Literature Review. World Neurosurgery, 128, 182-185. https://doi.org/10.1016/j.wneu.2019.05.002
Benyaich Z, et al. Acute Lumbar Spinal Subdural Hematoma Inducing Paraplegia After Lumbar Spinal Manipulation: Case Report and Literature Review. World Neurosurg. 2019;128:182-185. PubMed PMID: 31078801.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute Lumbar Spinal Subdural Hematoma Inducing Paraplegia After Lumbar Spinal Manipulation: Case Report and Literature Review. AU - Benyaich,Zakariae, AU - Laghmari,Mehdi, AU - Lmejjati,Mohamed, AU - Aniba,Khalid, AU - Ghannane,Houssine, AU - Ait Benali,Said, Y1 - 2019/05/09/ PY - 2019/04/28/received PY - 2019/05/01/accepted PY - 2019/5/13/pubmed PY - 2020/1/22/medline PY - 2019/5/13/entrez KW - Cauda equina syndrome KW - Spinal manipulative therapy KW - Spinal subdural hematoma KW - Surgical decompression SP - 182 EP - 185 JF - World neurosurgery JO - World Neurosurg VL - 128 N2 - BACKGROUND: Traumatic spinal subdural hematoma is an extremely rare occurrence that requires urgent investigation and most often prompt intervention. To our knowledge, this is the first reported case related to a spinal manipulative therapy. CASE DESCRIPTION: This report describes a case of traumatic lumbar subdural hematoma after a spinal manipulative therapy without any predisposing factor. A 23-year-old man was admitted to the emergency department for partial cauda equina syndrome after a spinal manipulation performed by a physiotherapist. Magnetic resonance imaging showed an acute spinal subdural hematoma at L2-L3 level with cauda equina compression. The patient underwent an emergency L2 laminectomy with evacuation of the hematoma. He recovered completely his neurologic functions after 1 week. CONCLUSION: Practitioners of spinal manipulations should be aware of spinal subdural hematoma as a possible complication. A rapid diagnosis with magnetic resonance imaging is mandatory, and emergency surgical decompression is usually the optimal treatment for spinal subdural hematomas with severe neurologic deficit. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/31078801/Acute_Lumbar_Spinal_Subdural_Hematoma_Inducing_Paraplegia_After_Lumbar_Spinal_Manipulation:_Case_Report_and_Literature_Review_ DB - PRIME DP - Unbound Medicine ER -