Postoperative Spinal Epidural Hematoma Following Microlumbar Discectomy: A Case Report

Abstract

The neurosurgical emergency called postoperative spinal epidural hematoma (pSEH) is a neurological complication that is rare but necessitates early diagnosis and decompression. We describe a case of a 55-year-old hypertensive female patient who presented with progressive acute lower limb weakness on both sides less than 24 hours after a two-level microlumbar discectomy. Emergency magnetic resonance imaging showed a large epidural hematoma between T11 and L5, which was compressing the thecal sac. Hemilaminectomy and hematoma evacuation yielded great neurological improvement in a few hours. The present case highlights the significance of early neurological surveillance after surgery, quick access to imaging, and multidisciplinary care. pSEH awareness, even in the postoperative lumbar case, is crucial for preventing irreversible neurological deficits and maximizing patient outcomes.