{"id":"4b0c12e2-7c4b-44e3-9531-3a8ee8b38df9","slug":"delayed-spinal-epidural-hematoma-following-t1-chance-fracture-an-illustrative-case-and-review-of-the-literature","title":"Delayed spinal epidural hematoma following T1 chance fracture: An illustrative case and review of the literature","authors":["Daniel Y. Chu","Garret P. Greeneway","Cody J. Falls","Paul S. Page","Azam S. Ahmed"],"abstract":"Background: A Chance fracture is a traumatic fracture of the thoracic or lumbar spine that occurs secondary to a flexion-distraction injury. Although patients with chance fractures rarely present with neurologic deficits, a subset may become symptomatic from spinal epidural hematomas (SEH) warranting emergent decompressive surgery. Case Description: An 87-year-old female on anticoagulation presented with a T1 Chance fracture after a fall. She was originally neurologically intact, but became paraplegic over the next 10 h. When the cervical/thoracic magnetic resonance revealed a SEH markedly compressing the cord between the C7-T1 levels, she underwent an emergent decompression; she also had a C5-T4 instrumented fusion. Postoperatively, she regained lower limb function, but expired on postoperative day 5 due to respiratory complications likely attributed to the prolonged surgery for the spinal instrumentation. Conclusion: Delayed SEH rarely occur following spinal Chance fractures. Here, an 87-year-old female on anticoagulation developed the 10-h delayed onset of a SEH with paraplegia attributed to a T1 Chance fracture at the C7-T1 level. Although she regained neurological function following the emergent decompression, she expired 5 days later likely due to the extended operative time/blood loss from the C5-T4 fusion that could have been avoided.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/4b0c12e2-7c4b-44e3-9531-3a8ee8b38df9/featured/hero-1781560640303.png","publishDate":"2022-12-23T00:00:00.000Z","doi":"10.25259/SNI_1046_2022","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2022/12/12070/SNI-13-593.pdf"}