Open AccessEpidural hematoma after total hip arthroplasty in ankylosing spondylitis patient
Author(s) -
Jia Li,
Ke Qin,
Yongjin Zhang,
Xue Cheng,
Weidong Xu
Publication year - 2017
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000006859
Subject(s) - medicine , ankylosing spondylitis , surgery , epidural hematoma , hematoma , laminectomy , decompression , arthroplasty , population , lumbar , spondylitis , spinal cord , environmental health , psychiatry
Rationale: Ankylosing spondylitis (AS) can affect the hip joint, causing deformity and disability. Total hip arthroplasty can obviously relieve the pain of the hip joint, and reconstruct the function of hip joint. Epidural anesthesia in this patient population has high risk of epidural hematoma, but the reason is unclear. Patient concerns: A 44-year-old man diagnosed with AS underwent total hip arthroplasty. Diagnoses: Six days after operation, he was diagnosed epidural hematoma. Interventions: Laminectomy and decompression surgery was performed. Outcomes: At the last follow-up, he recovered the feeling and function of lower limbs. A literature review was undertaken to understand the incidence and risk factors. The incidence of spinal hematoma in this population is high and only probable risk factors are reported without further research. Lessons: Based on our review and the illustration of this case, AS patients have both lumbar and hip bony fusion. The exact bone canal caused by the lumbar puncture needle may play an important role in epidural hematoma. General anesthesia may be a better choice for this special patient cohort.