# Early Acute Spinal Subdural Hematoma Following Multilevel Bilateral Lumbar Decompression via a Unilateral Approach: A Case Report

## TL;DR

A patient developed a rare spinal hematoma shortly after lumbar surgery, highlighting the importance of early detection and emergency treatment.

## Contribution

This is the first reported case of early acute spinal subdural hematoma following minimally invasive lumbar decompression.

## Key findings

- Acute spinal subdural hematoma can occur within hours after lumbar decompression surgery.
- Prompt re-exploration and hematoma evacuation are critical for managing this complication.
- Neurological deficits following spinal surgery should raise suspicion for SSH.

## Abstract

We report a case diagnosed with lumbar spinal stenosis who underwent reoperation for a spinal subdural hematoma (SSH) following minimally invasive lumbar decompression in the early postoperative period. This study aimed to discuss the management of this rare complication.

A female patient with spinal stenosis underwent an uncomplicated left-sided, unilateral, three-level lumbar hemilaminectomy for bilateral decompression. However, six hours after surgery, she developed numbness and weakness in the right foot. An urgent lumbar MRI revealed an acute SSH at the operated levels. When paraparesis developed within minutes, the patient underwent emergency re-exploration. To our knowledge, this is the first reported case of SSH developing in the very early postoperative period.

SSH is a rare complication that should be considered in patients presenting with progressive neurological deficits after spinal surgery. Prompt evacuation of the hematoma remains the most appropriate treatment.