Spinal Epidural Hematoma in a Patient With Ankylosing Spondylitis Caused by After Trauma Thoracic Vertebra Burst Fracture: A Case Report

Öz

Spinal epidural hematoma is a rare clinical disorder that might result in permanant neurological deficit and death when left untreated. We present a 59 year old male admitted to our emergency department with back pain falling to the walnut tree, and paraplegia, and being diagnosed with do not make the intra-channel compression in the T12 vertebral burst fractures and spinal epidural hematoma.

Anahtar Kelimeler

• -

Ankilozan Spondilitli Bir Olguda Travma Sonrası Torakal Vertebra Burst Kırığı ve Spinal Epidural Hematom: Olgu Sunumu

Öz

Spinal epidural hematom nadir görülen, erken tanınıp, tedavi edilmediğinde kalıcı nörolojik defisit ve ölüm ile sonuçlanabilen bir acildir. Bu yazıda, acil servise ceviz ağacından düşme, sırt ağrısı ve parapleji ile başvuran, incelemeler sonrasında; nadir olarak görülen çökme ve kanal içi basısı yapmayan T12 vertebra Burst kırığı ile birlikte spinal epidural hematom tanısı alan 59 yaşındaki erkek hasta sunuldu.

Anahtar Kelimeler

• Spinal epidural hematom, Akut parapleji, Steroid tedavi, Vertebral kırık, Cerrahi tedavi

Kaynakça

1. Ludwig Steven C. and Zarro Christopher M. Complications encountered in the management of patients with ankylosing spondylitis. In: Vaccaro AR, Regan JJ, Crawford AH, Benzel EC, Anderson EG. (Eds). Complication of pediatric and adult spinal surgery. New York: Marcel Dekker 2004; 279-91.
2. Jacobs WB, Fehlings MG. Ankylosing spondylitis and spinal cord injury: origin, incidence, management, and avoidance. Neurosurg Focus 2008; 24: E12.
3. Ruf M, Rehm S, Poeckler-Schoeniger C, Merk HR, Harms J. Iatrogenic fractures in ankylosing spondylitis-a report of two cases. Eur Spine J 2006; 15: 100-4.
4. Foo D, Rossier AB. Post-traumatic spinal epidural hematoma. Neurosurgery 1982; 11: 25–32.
5. Bohlman HH. Acute fractures and dislocation of the cervical spine. J Bone Joint Surg Am 1979; 61: 1119-42.
6. Özkan S, Duman A, Durukan P, Avşaroğulları L, İpekci A, Mutlu A. Ceviz ağacından düşmeye bağlı yaralanmaların özellikleri. Türkiye Acil Tıp Dergisi 2010; 10: 51-4.
7. Özdemir HM, Erkoçak Ö, Demirayak M, Ögün T. Ankilozan spondilitli bir olguda travma sonrası servikal Chance kırığı:Olgu sunumu. Ulus Travma Derg 2006; 12: 79-82.
8. Savaş S, İlgün E, Görgülü A, Yeşildağ A. Ankilozan Spondilitli bir hastada minör travma ile gelişen servikal omurilik yaralanması: Olgu Sunumu. Romatizma 2008; 23: 28-30.

9. Samartzis D, Dip EBHC, Anderson DG, Shen FH. Multiple and simultaneous spine fractures in ankylosing spondylitis. Spine 2005; 30: 11-5.
10. El Maghraoui A. Osteoporosis and Ankylosing Spondylitis. Joint Bone Spine 2004; 71: 291-5.
11. Mitra D, Elvins DM, Speden DJ, Collins AJ. The prevalence of vertebral fractures in mild ankylosing spondylitis and their relationship to bone mineral density. Rheumatology 2000; 39:85-9.
12. Ruf M, Rehm S, Poeckler-Schoeniger C, Merk HR, Harms J. Iatrogenic fractures in ankylosing spondylitis- a report of two cases. Eur Spine J 2006; 15: 100-4.
13. Harding JR, McCall IW, Park WM, Jones BF. Fracture of the cervical spine in ankylosing spondylitis. Br J Radiol 1985; 58:3-7.
14. Kılınçoğlu BF, Mukaddem AM, Altınörs N. Hipertansif spinal epidural hematomun neden olduğu akut parapleji. Ulus Travma Derg 2005; 11: 73-5.
15. Lawton MT, Porter RW, Heiserman JE, et al. Surgical management of spinal epidural hematoma: relationship between surgical timing and neurological outcome. J Neurosurg 1995; 83: 1-7.
16. Rohde V, Kuker W, Reinges MHT et al. Microsurgical treatment of spontaneous and non-spontaneous spinal epidural haematomas: Neurological outcome in relation to aetiology. Acta Neurochir 2000; 142: 787-93.
17. Boukobza M, Guichard JB, Boissonet M et al: Spinal epidural hematom: Report 11 cases and rewiew literatüre. Neuroradiaolgy 1994; 36: 456-9.
18. Narberhaus B, Rivas I, Vilalta J, et al. Transient BrownSequard syndrome due to spontaneous spinal epidural hematoma. Neurologia. 2002; 17: 384-7.