{"id":"b06a43d2-b063-4644-9688-39d16a1f9e21","slug":"case-of-lumbar-ligamentum-flavum-hematoma-with-epidural-hematoma-resulting-in-cauda-equina-compression","title":"Case of lumbar ligamentum flavum hematoma with epidural hematoma resulting in cauda equina compression","authors":["Yoshinori Hisamitsu","Hisaaki Uchikado","Takehiro Makizono","Tomoya Miyagi","Takahiro Miyahara"],"abstract":"Background: Lumbar ligamentum flavum hematomas (LFHs) are rare. However, when they occur and contribute to epidural cauda equina compression, timely surgical intervention is frequently warranted. Case Description: A 69-year-old female presented with the left lower extremity sciatica and gait disturbance of 2 weeks’ duration that ultimately evolved into a paraparesis/cauda equina syndrome. When the lumbar MRI revealed left-sided L4-L5 epidural compression attributed to a hemorrhage into the hypertrophied ligamentum flavum (HLF), she successfully underwent a bilateral fenestration/decompressive procedure. Pathologically, neovascularization and rupture of the ventral layers of the degenerated and thickened HLF contributed to the LFH. Conclusion: Arterial neovascularization (i.e., arterial feeding vessels from paramuscular/prelaminar lumbar branches) contributed to a left-sided L4-L5 LFH that resulted in epidural cauda equina compression in a 69-year-old female. Following surgical focal fenestration/decompression, the patient’s symptoms/signs resolved.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/b06a43d2-b063-4644-9688-39d16a1f9e21/featured/hero-1781560700139.png","publishDate":"2022-11-25T00:00:00.000Z","doi":"10.25259/SNI_967_2022","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2022/11/12024/SNI-13-550.pdf"}