摘要脊柱术后症状性硬膜外血肿(SSEH)是脊柱术后少见但严重的并发症之一,若错过最佳治疗时机,可导致灾难性的神经功能障碍.早期诊断SSEH是恢复神经功能的关键,其中MRI对于判断血肿的位置和范围以及制定手术方案具有重要价值.与发生SSEH相关的风险因素可分为术前因素、术中因素和术后因素.通过控制风险因素、术中确切止血及合理的围手术期处理等,可以最大程度地减少SSEH的发生.对于轻度瘫痪的SSEH患者可以尝试保守治疗,对于严重或进行性神经损伤(肌力<3级)和难以耐受的神经根性疼痛的SSEH患者应尽快施行血肿清除和神经减压.

abstractsSymptomatic spinal epidural hematoma ( SSEH) following spinal surgery is rare but one of the serious complications. SSEH can leave devastating neurological consequences if missing the optimal timing for treatment. The early diagnosis of SSEH is critical to the neurologic recovery, and MRI examination can help to check the location and the scope of the hematoma and provide imaging information for surgical operation. The risk factors of SSEH can be divided into preoperative factors, intraoperative factors and postoperative factors. The occurrence of SSEH can be minimized by controlling the risk factors, exact hemostasis and reasonable perioperative management. Patients with mild paralysis can choose conservative treatment, while patients with severe or progressive nerve injury ( manual muscle testing < 3 ) and unendurable nerve root pain should choose to clean the hematoma and decompress the nerve as soon as possible.