The incidence of symptomatic postoperative epidural hematoma after minimally invasive lumbar decompression: a single institution retrospective review

Abstract Objective Postoperative epidural hematoma (PEDH) after minimally invasive lumbar laminectomy (MILL) can lead to significant morbidity and healthcare cost. The incidence is not well characterized in the literature as compared with traditional open techniques. Our aim was to define the incidence of PEDH after MIS lumbar decompression procedures and evaluate strategies for reduction of PEDH. Patients and Methods A retrospective review of a prospectively collected database was queried from January 2013 to September 2018 for all patients that underwent a minimally invasive lumbar laminectomy or laminotomy, with or without discectomy, for which the goal was decompression alone. Charts were reviewed to see the operation type and whether the patient developed a postoperative epidural hematoma. Results 1,004 cases were identified and reviewed. The overall PEDH rate was 1.4% (14/1004). 78.5% (11/14) of cases involved at least a single level laminectomy. 21.4% (3/14) involved a laminotomy alone or with discectomy. 64.3% (9/14) of patients presented with a neurological deficit. Conclusions The rate of PEDH after MIS lumbar decompression procedures is 1.4%. A majority of patients presented with a neurological deficit.