Case ReportSpinal Epidural Hematoma After Removal of an Epidural Catheter Case Report and Review of the LiteratureMiyazaki, Masashi MD; Takasita, Mitsuhiro MD; Matsumoto, Hirofumi MD; Sonoda, Hironori MD; Tsumura, Hiroshi MD; Torisu, Takehiko MDAuthor Information From the Department of Orthopaedic Surgery, Oita Medical University, Oita, Japan. Received for publication February 9, 2004; accepted April 8, 2004. Reprints: Dr. M. Miyazaki, Department of Orthopaedic Surgery, Oita Medical University, Idaigaoka 1-1, Hasama-machi, Oita-gun, Oita 879-5593, Japan (e-mail: [email protected]). Journal of Spinal Disorders & Techniques: December 2005 - Volume 18 - Issue 6 - p 547-551 doi: 10.1097/01.bsd.0000128692.44276.cf Buy Metrics Abstract We report a case of spinal epidural hematoma after removal of an epidural catheter. The patient had no background of anticoagulant therapy or coagulopathy; sudden severe back pain occurred immediately after removal of the catheter. The chance of this occurring is estimated to be between 1:150,000 and 1:190,000. We studied 40 previous reports from 1952 to 2000, and we also investigated anticoagulant therapy and pathologic states, puncture difficulties and bleeding at the point of insertion, and its onset. In 23 cases (57.5%), anticoagulant therapy had been performed, and in 5 cases (12.5%), coagulopathy or liver dysfunction had been recognized. In 20 cases (50%), the initial symptoms were recognized within 24 hours after removal of the epidural catheter. Although spinal epidural hematoma is a very rare condition, it is a serious complication of continuous epidural anesthesia. © 2005 Lippincott Williams & Wilkins, Inc.