Extended posture of lumbar spine precipitating cauda equina compression arising from a postoperative epidural clot

J Orthop Sci. 2001;6(1):88-91. doi: 10.1007/s007760170030.

Abstract

We report a patient with nonoperatively treated acute cauda equina compression arising from an epidural clot that developed after decompressive surgery for lumbar canal stenosis. A 43-year-old woman underwent lumbar laminotomy, and was symptom-free for 3 hours; but this was followed by paresis. Postoperative myelography showed obstruction of the contrast column at the level of the laminotomy; this was relieved by hyperflexion of the lumbar spine. With sustained hyperflexion of the lumbar spine, all neurologic deficits were completely resolved within 5 days. Lumbar lordosis may be present when a patient lies in the supine position on a flat bed with the hips and knees extended; this may exacerbate dural constriction caused by an epidural clot following posterior lumbar spinal surgery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cauda Equina
  • Female
  • Hematoma, Epidural, Cranial / complications*
  • Humans
  • Laminectomy
  • Lordosis / complications
  • Lumbar Vertebrae / surgery
  • Myelography
  • Postoperative Complications
  • Posture*
  • Spinal Cord Compression / etiology*
  • Spinal Cord Compression / physiopathology*
  • Spinal Stenosis / surgery