Kazumasa Ishibashi

Chronic lumbar epidural hematoma in a patient who had spondylolysis at the third lumbar vertebra. Report of a rare case involving a seventeen-year-old adolescent.

A spinal epidural hematoma may result from one of many causes, including coagulopathy, trauma, a vascular lesion, iatrogenesis, and spontaneous occurrence2,4,6,7,11,12. Groen and van Alphen7 reviewed the cases of 333 patients who had a spontaneous spinal epidural hematoma; they had excluded patients in whom the hematoma had occurred after a traumatic episode involving spinal dislocation or fracture, after epidural anethesia, after diagnostic lumbar puncture, after an operation, or in association with a tumor in the spinal canal. Of the 333 patients, forty (12 per cent) had a lumbar epidural hematoma. Overall, fifty-five (17 per cent) of the patients were younger than twenty years old, and only four (7 per cent) of these young patients had a spontaneous lumbar epidural hematoma. Boyd and Pear reported that a hematoma caudad to the level of the conus medullaris was more likely to be chronic because the spinal roots appear to tolerate pressure better than the spinal cord does. In a review of the literature, we found four cases of lumbar epidural hematoma in patients who were younger than twenty years old3,7,17,21, and we compared these cases with that of our patient. A chronic spinal epidural hematoma is rare in young patients; it occurred in only two of the patients, including ours. We report the case of a young patient who had a chronic lumbar epidural hematoma and spondylolysis at the third lumbar vertebra. The patient, a seventeen-year-old high-school student, had radicular pain in the left lower extremity when he was first seen by us in 1991. He was a rugby player (center prop position number three), and, in early December 1991, he had pain on the left side of the low back …

Quantitive Computed Tomography of The Lumbar Spine

Quantitive Computed Tomography (QCT) is one of the most successful method in determining bone mineral content of the spine.Lumbar mineral contents of one hundred patients (thirty-one males and sixty-nine females) were determined by the QCT method.Following results were obtained.1) In the female patients, bone mineral content of the lumbar spine severely decreased to marginal value of abnormality, boundary of their anomeria.2) Bone mineral contents of the cases of trochanteric fractures were less than the cases of femoral neck fracture.3) The results of QCT method were related to the classification system on plain x-ray photographs.