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September 28, 2025

Spontaneous lumbar epidural hematoma induced by acute disc herniation: A rare cause of cauda equina syndrome successfully treated with minimally invasive surgery – A case report

Key Points

Immediate neurological improvement followed minimally invasive surgery for spontaneous spinal epidural hematoma in a 63-year-old man.
A ruptured epidural vein was identified during surgery, emphasizing the role of timely intervention in cauda equina syndrome management.
Magnetic resonance imaging confirmed the presence of an L2/3 disc herniation and adjacent hematoma compressing the thecal sac.
The patient's successful recovery showcases the efficacy of minimally invasive surgical techniques for rare spinal conditions.

Abstract

Background: Spontaneous spinal epidural hematoma in the lumbar spine is rare, and its occurrence in conjunction with acute disc herniation is exceptionally uncommon. Case Description: A 63-year-old male with chronic back pain experienced sudden exacerbation and progressive bilateral lower limb weakness. Magnetic resonance imaging with contrast revealed a sequestrated L2/3 disc and adjacent epidural hematoma compressing the thecal sac. Minimally invasive decompression and hematoma evacuation were performed. A ruptured epidural vein was identified intraoperatively. Neurological improvement was immediate, and the patient was discharged on postoperative day 2. Conclusion: This case underscores a rare etiology of cauda equina syndrome and highlights the importance of prompt diagnosis and minimally invasive surgical intervention for optimal outcomes.

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Cite This Study

Obeidat et al. (Fri,) studied this question.

synapsesocial.com/papers/68d9052941e1c178a14f58d2 https://doi.org/https://doi.org/10.25259/sni_791_2025

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