Acute Spinal Epidural Hematoma after Acupuncture: Personal Case and Literature Review.

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Acute Spinal Epidural Hematoma after Acupuncture: Personal Case and Literature Review.

World Neurosurg. 2017 Apr 01;:

Authors: Domenicucci M, Marruzzo D, Pesce A, Raco A, Missori P

Abstract
BACKGROUND: Spinal acupuncture is a relatively safe and common analgesic treatment, but it may be complicated by serious adverse effects such as direct spinal cord and nerve root injury, subdural empyema and epidural abscesses. In this report we are comparing our case of an extremely uncommon spinal epidural hematoma which appeared following treatment by acupuncture with other similar documented cases.
CASE DESCRIPTION: This is the case of a 64-year-old man who presented a left hemiparesis associated with paraesthesias. This appeared several hours after acupuncture treatment for left lumbosciatic pain. The Cervico-thoracic Spine MRI scan showed a cervico-thoracic spinal epidural hematoma from C2 to T12. The rapid improvement of the patient's neurological symptoms justified the adoption of a conservative treatment strategy. This gave excellent long-term results.
CONCLUSIONS: Although a post acupuncture spinal epidural hematoma (paSEH) is very rare, there are only 6 documented cases, it is a possible complication from acupuncture on the back. The use of very thin needles can produce bleeding, probably venous, in the epidural space. In general this evolves more slowly than other kinds of epidural hematoma. The symptoms are also less severe, warranting less frequent surgical intervention and in general there is a good outcome. The possibility of hematoma makes acupuncture contraindicated in patients who have coagulation disorders. The onset of severe spinal pain after spinal or paraspinal acupuncture treatment should lead to the suspicion of a paSEH and a spinal MRI should be carried out.

PMID: 28377250 [PubMed - as supplied by publisher]

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