Spinal epidural hematoma after spinal manipulation therapy: Report of three cases and a literature review

Table 1 Summary of cases of spinal epidural hematoma secondary to spinal manipulation therapy

Ref.	Age (yr), sex	Symptoms	Interval to symptom onset	Level	Location of SEH	Treatment	Outcome
Zupruk and Mehta[12], 1989	86, Male	Brown-Sequard Syndrome	24 h	C2-7	Posterolateral	Surgery	Recovery
Segal et al[28], 1996	33, Female	Left upper limb paresis	15 min	C4-6	Posterolateral	Surgery	Recovery
Ruelle et al[25], 1999	64, Female	Paraparesis	2 h	T9-11	Not reported	Surgery	Recovery
Tseng et al[13], 2002	67, Female	Brown-Sequard syndrome	Immediately	C3-5	Posterolateral	Surgery	Recovery
Saxler and Barden[31], 2004	27, Female	Headache	10 min	C1-S1	Not reported	Conservative	Recovery
Whedon et al[9], 2006	79, Male	Lower extremity paralysis	Immediately	C4-5	Posterolateral	Surgery	Recovery
Gouveia et al[26], 2007	34, Male	Tetraplegia	Few hours	C3-6	Not reported	Surgery	Recovery
Domenicucci et al[16], 2017	52, Female	Brown-Sequard Syndrome	Immediately	C3-T1	Posterolateral	Surgery	Recovery
Solheim et al[10], 2007	77, Male	Right lower extremity paresis	Immediately	L3-4	Posterior	Surgery	Partial recovery
Heiner[32], 2009	38, Female	Neck and arms pain numbness	4 h	C1-4	Posterolateral	Conservative	Recovery
Lidder et al[21], 2010	64, Male	Hemiparesis	Immediately	C4-6	Not reported	Surgery	Partial recovery
Lee et al[27], 2011	38, Female	Lower extremity paralysis	Immediately	T1-7	Posterolateral	Surgery	Recovery
Huang et al[14], 2015	40, Male	Hemiparesis	Immediately	C2-T2	Posterolateral	Surgery	Recovery
Ling et al[6], 2017	33, Male	Tetraplegia	Immediately	C4-7	Posterolateral	Surgery	Die
Fattahi et al[30], 2017	44, Female	Tetraplegia	not reported	C1-4	Anterior	Conservative	Recovery
Ryu et al[29], 2018	38, Male	Paraparesis	Immediately	C6-T1	Anterior	Conservative	Recovery
Vanichkulbodee et al[18], 2019	20, Male	Paraparesis	3 d	C6-T2	Posterolateral	Surgery	not reported
Cooper et al[11], 2019	63, Male	Tetraplegia	1 d	C6-7	Posterior	Surgery	Partial recovery
Present case one	30, Female	Neck and arms pain numbness	Immediately	C6-7	Posterolateral	Surgery	Recovery
Present case two	55, Male	Lower extremity paralysis	1 d	T1-3	Posterior	Surgery	Recovery
Present case three	28, Male	Paraparesis	4 h	T1-2	Posterolateral	Surgery	Recovery

SEH: Spinal epidural hematoma.