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Secondary hemorrhage is a complication which can develop after spine surgery. To prevent progressive neurological deficit caused by an expanding hematoma, drains are inserted to build an outflow for the trickling blood. Minimally invasive spine surgery reduces local tissue damage and associated complications. In a prospective follow up study 882 patients receiving lumbar single level decompression surgery were assessed for a postoperative hemorrhage. Patients undergoing single level decompression for degenerative spinal stenosis and / or lumbar disk herniation were included. Three out of 882 patients (0.34%) developed a secondary hemorrhage with the indication for revision surgery. Second surgery was done on the same day in one case and after 5 and 8 days in the two other patients, respectively. In all patients persisting sciatic pain was the main indication. Increasing neurological deficit was observed in one patient immediately after surgery. Secondary hemorrhage is a rare complication after minimally invasive lumbar spine surgery. Even without inserting any drainage system the rate for compression related neurological deficit is very low.

Low Incidence of Secondary Hemorrhage after Single Level Lumbar Decompression