Clinical analysis of spontaneous intraspinal hemorrhage in adults
ZHANG Youqiang1 YAN Ling1 LIAO Wei1 WANG Guang1 CHEN Xiaoheng1 DENG Jiang1 SHEN Yuguang2
1.Department of Orthopedics, the Third Affiliated Hospital of Zunyi Medical University the First People’s Hospital of Zunyi, Guizhou Province, Zunyi 563000, China;
2.Department of Thoracic Surgery, the Third Affiliated Hospital of Zunyi Medical University the First People’s Hospital of Zunyi, Guizhou Province, Zunyi 563000, China
Abstract：Objective To investigate the clinical features, treatment options, and prognosis of spontaneous intraspinal hemorrhage in adults. Methods The clinical symptoms, signs, imaging data, causes of hemorrhage, treatment methods, and follow-up of 35 patients with spontaneous intraspinal hemorrhage who were admitted from January 2012 to May 2021 in the Department of Spinal Surgery, the First Affiliated Hospital of Zunyi Medical University and the Third Affiliated Hospital of Zunyi Medical University were retrospectively analyzed. Results There were 30 cases of dural hemorrhage and 5 cases of intramedullary hemorrhage. Hematoma was located in cervical vertebrae in 10 cases, thoracic vertebrae in 14 cases, lumbar vertebrae in 3 cases, cervical thoracic vertebrae in 3 cases, and thoracolumbar vertebrae in 5 cases. Surgical treatment was performed in 23 cases, conservative treatment in 9 cases, and refusal of surgery in 3 cases. All cases were followed up, and the improvement rate of neurological function was 87.5% at the last follow-up. The postoperative improvement rate of 8 patients with American Spinal Injury Association (ASIA) grade A was 50%. Conclusion ASIA grade A to C is recommended for emergency decompression, and conservative treatment is recommended for mild or progressive improvement of nerve injury. The more severe the neurological dysfunction, the worse the prognosis.
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