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. 2023 Jul 11;9(1):30.
doi: 10.1038/s41394-023-00589-z.

First report of lumbar spinal epidural hematoma after pelvic ring fracture

Moritz Wagner  1 , Tino Riegger  2 , Alexander Brunner  2 , Dietmar Dammerer  3 , Benjamin Ulmar  4 , Hedye Aliabadi  2
Affiliations

First report of lumbar spinal epidural hematoma after pelvic ring fracture

Moritz Wagner et al. Spinal Cord Ser Cases. .

Abstract

Introduction: Spinal epidural hematoma is a rare condition that most commonly occurs as a complication of spinal surgery. For patients with neurological deficits, surgical decompression can generally provide good outcome.

Case: A 56-year-old, otherwise healthy, patient was admitted to the orthopedic emergency department with a pelvic ring fracture. Over the course of 4 days, a lumbar spinal epidural hematoma developed, with the patient complaining of pain radiating to the S1 dermatome and saddle paresthesia. The hematoma was surgically decompressed, and the patient had a complete recovery.

Discussion: To our knowledge, this is the first report of a spinal epidural hematoma after pelvic ring fracture. The etiology of spinal epidural hematoma is diverse, but it is most frequently observed after spinal surgery. It has rarely been observed after lumbar spinal fractures, nearly exclusively in patients with ankylosing spondylitis.

Conclusion: Pelvic ring fracture might result in spinal epidural hematoma. The presence of neurological deficits after such fractures is an indication for lumbosacral MRI. Surgical decompression will generally resolve the neurological symptoms.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Anteroposterior radiograph of the pelvis showing a right superior and inferior pubic ramus fracture (lateral compression type 1).
Fig. 2
Fig. 2
CT images showing the fracture at the right pars lateralis of the sacrum (lateral compression type 1).
Fig. 3
Fig. 3
CT images showing the fracture at the right ipsilateral right superior and inferior pubic ramus (lateral compression type 1).
Fig. 4
Fig. 4
Lumbosacral T2-weighted MRI 3 days after admission showing the spinal epidural hematoma.
Fig. 5
Fig. 5
Lumbosacral T2-weighted MRI at 6 weeks after surgical decompression showing complete resorption of the hematoma.
See this image and copyright information in PMC

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