An unusual acute onset hard and small volume epidural blood clotting after anterior cervical discectomy with tetraparetic neurological findings

Abstract

Anterior cervical discectomy and fusion (ACDF) is one of the most commonly used surgical method to treat a variety of disorders in the cervical spine. Although, the incidence of complication related to ACDF is low, hematomas can be confronted after surgery. We report a 52-year-old male patient presented with complaints of paraesthesia and sensory loss in the upper extremities. Magnetic resonance imaging (MRI) showed a large central-right paracentral protrusion resulting in narrowing of the spinal channel at the level of C5-C6 accompanied by spinal cord compression and bilateral foraminal stenosis. ACDF was performed at this level. Five hours after surgery, sudden onset paraesthesia and tetraparesis developed. Urgent cervical MRI depicted acute filling half of the discectomy cavity, compressing the dural sac and spinal cord. The patient underwent revision surgery and the symptoms improved postoperatively. The patient received conservative therapy and was discharged without any nerological problem. Despite being a rare condition, sudden onset of neurological symptoms such as tetraparesis after ACDF surgery should remind the presence of hematoma at the surgical site.