TY - JOUR
T1 - Extent of spinal canal obliteration as prognostic factor for functional outcome in patients with spontaneous spinal epidural hematoma
T2 - a retrospective study
AU - Marhold, Franz
AU - Popadic, Branko
AU - Rechberger, Philipp
AU - Berger-Brabec, Sonja
AU - Decristoforo, Ingo
AU - Sherif, Camillo
AU - Scheichel, Florian
N1 - Funding Information:
The authors want to appreciate the contribution of NÖ Landesgesundheitsagentur, legal entity of University Hospitals in Lower Austria, for providing the organizational framework to conduct this research.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.
PY - 2021/12
Y1 - 2021/12
N2 - BACKGROUND: Spontaneous spinal epidural hematoma (SSEDH) is a rare condition with potentially devastating consequences. Known prognostic factors are short time to surgery, preoperative neurologic condition, and age. The aim of this study was to investigate the impact of the transversal hematoma extent with its subsequent spinal canal obliteration on outcome in patients with SSEDH.METHODS: A retrospective study including all patients that underwent surgery due to SSEDH at the University Hospital of St. Poelten between 1/7/2005 and 30/6/2020 was conducted. The percentage of spinal canal obliteration at the level where the hematoma was most prominent was calculated and correlated to functional outcome.RESULTS: A total of 17 patients could be included in this study. Preoperative ASIA impairment scale showed positive correlation with postoperative outcome (p = 0.005). Patients with a favorable outcome (ASIA D and E) showed a statistically significant lower mean obliteration of the spinal canal by the hematoma with 46.4% (± 8%) in comparison to patients with an unfavorable outcome with 62.1% (± 6%, p = 0.001). A cut-off of 51% yielded a sensitivity and specificity for favorable outcome of 100% and 70% respectively (area under the ROC 0.93, p < 0.001).CONCLUSION: Preoperative percentage of spinal canal obliteration is statistically significant lower in patients with favorable outcome in surgically treated patients with spontaneous spinal epidural hematoma.
AB - BACKGROUND: Spontaneous spinal epidural hematoma (SSEDH) is a rare condition with potentially devastating consequences. Known prognostic factors are short time to surgery, preoperative neurologic condition, and age. The aim of this study was to investigate the impact of the transversal hematoma extent with its subsequent spinal canal obliteration on outcome in patients with SSEDH.METHODS: A retrospective study including all patients that underwent surgery due to SSEDH at the University Hospital of St. Poelten between 1/7/2005 and 30/6/2020 was conducted. The percentage of spinal canal obliteration at the level where the hematoma was most prominent was calculated and correlated to functional outcome.RESULTS: A total of 17 patients could be included in this study. Preoperative ASIA impairment scale showed positive correlation with postoperative outcome (p = 0.005). Patients with a favorable outcome (ASIA D and E) showed a statistically significant lower mean obliteration of the spinal canal by the hematoma with 46.4% (± 8%) in comparison to patients with an unfavorable outcome with 62.1% (± 6%, p = 0.001). A cut-off of 51% yielded a sensitivity and specificity for favorable outcome of 100% and 70% respectively (area under the ROC 0.93, p < 0.001).CONCLUSION: Preoperative percentage of spinal canal obliteration is statistically significant lower in patients with favorable outcome in surgically treated patients with spontaneous spinal epidural hematoma.
KW - Hematoma, Epidural, Spinal/diagnostic imaging
KW - Humans
KW - Magnetic Resonance Imaging
KW - Prognosis
KW - Retrospective Studies
KW - Spinal Canal/diagnostic imaging
KW - Spine
KW - Outcome
KW - Hematoma extent
KW - Spontaneous spinal epidural hematoma
KW - Spinal hematoma
UR - http://www.scopus.com/inward/record.url?scp=85116724875&partnerID=8YFLogxK
U2 - 10.1007/s00701-021-05011-x
DO - 10.1007/s00701-021-05011-x
M3 - Journal article
C2 - 34633546
SN - 0001-6268
VL - 163
SP - 3279
EP - 3286
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
IS - 12
ER -