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Extent of spinal canal obliteration as prognostic factor for functional outcome in patients with spontaneous spinal epidural hematoma: a retrospective study

  • Original Article - Spine - Other
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Acta Neurochirurgica Aims and scope

Abstract

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.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

SSEDH:

: Spontaneous spinal epidural hematoma

ASIA:

: American Spinal Injury Association impairment scale

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Acknowledgements

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.

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Authors and Affiliations

  1. Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria

    Franz Marhold, Branko Popadic, Philipp Rechberger, Sonja Berger-Brabec, Ingo Decristoforo, Camillo Sherif & Florian Scheichel

  2. Department of Neurosurgery, University Hospital St. Pölten, Dunant-Platz 1, 3100, St. Pölten, Austria

    Franz Marhold, Branko Popadic, Philipp Rechberger, Sonja Berger-Brabec, Ingo Decristoforo, Camillo Sherif & Florian Scheichel

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  1. Franz Marhold
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  2. Branko Popadic
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  3. Philipp Rechberger
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  4. Sonja Berger-Brabec
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  5. Ingo Decristoforo
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  6. Camillo Sherif
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  7. Florian Scheichel
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Contributions

Conception and design: Scheichel. Acquisition of data: Scheichel, Marhold, Berger-Brabec. Analysis and interpretation of data: Marhold, Scheichel. Drafting the article: Marhold, Popadic, Scheichel. Critically revising the article: Marhold, Scheichel, Popadic, Rechberger, Berger-Brabec, Decristoforo, Sherif. Reviewed submitted version of manuscript: Marhold, Scheichel. Approved the final version of the manuscript on behalf of all authors: Marhold, Scheichel. Statistical analysis: Scheichel. Study supervision: Marhold, Scheichel.

Corresponding author

Correspondence to Florian Scheichel.

Ethics declarations

Ethical Approval

This retrospective study was approved by the Ethics Committee of the Karl Landsteiner University of Health Sciences, Krems, Austria, approval no.: 1056/2020. The study was conducted in accordance with the ethical standards of our institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare no competing interests.

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Marhold, F., Popadic, B., Rechberger, P. et al. Extent of spinal canal obliteration as prognostic factor for functional outcome in patients with spontaneous spinal epidural hematoma: a retrospective study. Acta Neurochir 163, 3279–3286 (2021). https://doi.org/10.1007/s00701-021-05011-x

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  • DOI: https://doi.org/10.1007/s00701-021-05011-x

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