J Neurol Surg A Cent Eur Neurosurg 2019; 80(03): 220-222
DOI: 10.1055/s-0038-1676594
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Multilevel Spinal Combined Subdural/Subarachnoid Hemorrhage Resulting in Paraplegia: An Unusual Complication of Kyphoplasty

C. von der Brelie
1  Department of Neurosurgery, Georg August University of Göttingen, Medical Center, Göttingen, Germany
,
I. Fiss
1  Department of Neurosurgery, Georg August University of Göttingen, Medical Center, Göttingen, Germany
,
V. Rohde
1  Department of Neurosurgery, Georg August University of Göttingen, Medical Center, Göttingen, Germany
› Author Affiliations
Further Information

Publication History

28 March 2018

24 July 2018

Publication Date:
01 February 2019 (eFirst)

Abstract

Background Paraplegia due to spinal combined subdural/subarachnoid hemorrhage is an extremely rare complication following percutaneous spinal augmentation procedures.

Methods A 63-year-old male patient presented with severe neurologic decline (paraplegia with sensory and autonomic dysfunction) resulting from a multilevel spinal subarachnoid hemorrhage shortly after bilateral kyphoplasty.

Results Reduction of intrathecal pressure via multiple dural and arachnoidal incisions and removal of the hematoma resulted in a good neurologic recovery with surgical decompression even though evacuation was performed with a significant delay after the onset of neurologic worsening.

Conclusion Spinal augmentation procedures should only be performed in a setting where management of complications can also be diagnosed and performed. Robot-assisted or navigation-assisted pedicle perforation should be considered because complications can be reduced significantly.