Work

Conservative management of a cervical hematoma after anterior cervical discectomy and fusion: A case report

Year: 2025

Type: article

Abstract: INTRODUCTION AND IMPORTANCE: With an incidence ranging from 0.4 % to 2.4 %, post-operative hematoma after anterior cervical discectomy and fusion (ACDF) is considered as potentially fatal since it can rapidly lead to acute airway obstruction and respiratory failure. CASE REPORT: A 31-year-old male patient underwent a 2-level ACDF. On postoperative day 2, the patient developed thoracic pain and dysphagia. Imaging revealed a cervical hematoma without airway compromise or other critical symptoms. Conservative management was initiated with corticosteroids and close monitoring. Over the next several days, the hematoma reduced in size, and the patient recovered without requiring surgical intervention. CLINICAL DISCUSSION: Hematoma formation after ACDF is rare but can be life-threatening due to potential airway compromise, often necessitating reoperation. While the patient had a large hematoma, conservative management was chosen due to a patent airway, normal vitals, and symptom resolution after 8 h, avoiding the risks of surgery. CONCLUSION: This case highlights that with careful patient selection, including stable vital signs, patent airway, and favorable response to steroids, conservative management may avoid the morbidity of reoperation.

Source: International Journal of Surgery Case Reports

DOI: 10.1016/j.ijscr.2025.111132

Authors: Mohammad Daher, Gilles el Hage, Andrea Achkouty, Nadim Khoueir, Amer Sebaaly

Institutions: Brown University, Hôtel-Dieu de France

Language: English

Topic: Cervical and Thoracic Myelopathy

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,090