Acute spinal subdural haematoma complicating a posterior spinal instrumented fusion for congenital scoliosis : A case report

Article Article scientifique Rapport de cas Acute spinal subdural haematoma complicating a posterior spinal instrumented fusion for congenital scoliosis : A case report eng 2023-07-16 author Michon Du Marais Godefroy Division of Paediatric Orthopaedics and Traumatology Unit, Geneva University Hospitals and Geneva University, Geneva 1205, Switzerland. 762135 author Tabard Anne Division of Paediatric Orthopaedics, Geneva University Hospitals and Geneva University, Geneva 1205, Switzerland. anne.tabard@hcuge.ch. 849081 author Dayer Romain Olivier Pierre Division of Paediatric Orthopaedics, Geneva University Hospitals and Geneva University, Geneva 1205, Switzerland. 502314 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) 4890-4896 10.12998/wjcc.v11.i20.4890 37583984 2307-8960 PMC10424052 https://www.wjgnet.com/2307-8960/full/v11/i20/4890.htm Background: Acute spinal subdural haematoma (ASSH) is a rare and potentially devastating condition with a variable prognosis. Previously described subdural haematomas were thought to have occurred spontaneously or be related to major or minor iatrogenic or traumatic injuries caused by surgery, spinal puncture or epidural anaesthesia. Other contributing pathologies have been described, such as intradural tumours or spinal arteriovenous malformations. ASSH has also been associated with anticoagulation therapy, haemostatic abnormalities and risk factors such as pregnancy. To the best of our knowledge, this case study described the first reported occurrence of an ASSH during spinal surgery in a paediatric patient. The patient was not known to have any coagulopathies, and no obvious vascular lesions were documented. The surgical procedure did not directly involve the dura mater, and no evident intraoperative dural tears were found. Case summary: We reported and discussed a case of ASSH complicating a posterior spinal instrumented fusion during surgery for paediatric congenital scoliosis. This condition has not been previously described. We made recommendations for facing such an occurrence, explored its aetiology in the context of malformation and discussed the benefits of neuromonitoring during scoliosis correction and the management protocol. We conducted a PubMed literature review for cases of paediatric ASSH and other closely related disorders. We reviewed recommendations regarding neuromonitoring and treatment management in such cases. Conclusion: ASSH is a rare complication of posterior spinal instrumented fusion. Published cases are more often associated with anticoagulation therapy or coagulopathy. Neuromonitoring is strongly recommended to detect and assess neurological status, thus enabling rapid diagnosis and treatment and facilitating early spinal decompression and a return to a normal neurological status. Acute spinal subdural haematoma Case report Congenital malformation Paediatric Posterior spinal instrumented fusion Scoliosis Somatosensory evoked potential Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 false 150 L'imagerie cérébrale 184 World journal of clinical cases 11 20 c954b10a-9e37-48ba-8b46-ff5e2643f126 Article (Published version) Public Article_scientifique_from_europePmc.pdf 1766302 application/pdf CC BY-NC-4.0 18e37cf3beea67e94ebfce7d3fa61f143fc083e23ff7df7f1e3da828415386cc openAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique

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Acute spinal subdural haematoma complicating a posterior spinal instrumented fusion for congenital scoliosis : A case report	World journal of clinical cases			2023	60	130

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Michon Du Marais, Godefroy