Spinal hematoma

Spinal hematoma is a very rare neurologic disorder with the potential to cause paralysis or death if not treated appropriately. Prompt diagnosis appears to be the most important aspect of assuring successful treatment and positive outcomes. There are several etiologies of spinal hematoma, such as spontaneous bleeding, trauma, coagulopathies, vascular malformations, and iatrogenic hemorrhage during lumbar puncture or neuraxial anesthesia. Although a spinal hematoma can occur in the pain clinic during procedures such as epidural steroid injections, it is very rare. Most of the available clinical information comes from small case series and isolated case reports of patients undergoing neuraxial anesthesia procedures. This article will not only offer the reader general information about spinal hematomas, it will summarize the current literature with respect to recommendations regarding neuraxial procedures during anticoagulant administration.