Abstract
Study DesignRetrospective cohort study.ObjectiveTo determine the incidence, grading, management, and clinical impact of postoperative spinal epidural hematoma (SEH) following cervical laminoplasty (LAMP) for degenerative cervical myelopathy (DCM).MethodsThis study analyzed 207 DCM patients who underwent LAMP between August 2022 and February 2024. Postoperative magnetic resonance imaging (MRI) within 48 h was used to assess SEH, graded based on radiological compression and clinical symptoms. A 3-month MRI evaluated epidural scar formation. Patient demographics, laboratory and operative variables, and clinical outcomes were compared between the SEH and non-SEH groups, and multivariable logistic regression analysis was performed to identify independent risk factors for SEH.ResultsSEH was identified in 72 patients (34.8%), of whom 71 (98.6%) were Grades 1-3 and managed conservatively. One patient (0.48%) developed neurological symptoms (Grade 4) requiring percutaneous drainage and achieved full recovery. No patients developed Grade 5 SEH. At the 3-month follow-up, epidural scar formation was observed in 5 (7.7%) patients in the SEH group and 3 (2.6%) in the non-SEH group (P = .141). Clinical outcomes, including Japanese Orthopaedic Association (JOA) scores, and neck Numerical Rating Scale (NRS) scores were comparable between groups at the 3-month follow-up. No independent predictors of SEH were identified.ConclusionsMRI-detectable postoperative SEH was observed in more than one-third of patients after LAMP, and most cases were asymptomatic. The proposed grading system may support stratified management. Clinical outcomes were comparable between groups, and epidural scar formation was more frequent in the SEH group, but not statistically significant.