• Huafeng Wang, Fengfei Lin, Guiqing Liang, and Yuhan Lin.
• Department of Spine Surgery, Fuzhou Second Hospital, The Third Clinical Medical College, Fujian Medical University, Fuzhou, China.
• Medicine (Baltimore). 2022 Jun 3; 101 (22): e29340e29340.

RationaleOsteoporotic vertebral compression fracture (OVCF) accompanying huge spinal epidural hematoma (SEH) is fairly rare. The aim of this report is to investigate the management strategies and treatment outcomes of OVCF accompanying SEH.Patient ConcernsAn 89-year-old female patient was admitted to hospital because of severe back pain and numbness of both lower limbs after a slight fall. The magnetic resonance imaging examination of the patient showed a fresh compression fracture at L2 accompanying a large dorsal SEH which extended from the T12 to L3 and deformed the spinal cord.DiagnosisThe patient was diagnosed with OVCF accompanying SEH.InterventionsGiven mild neurologic deficits, the hematoma was not treated, and the patient underwent percutaneous vertebroplasty (PVP) only.OutcomesAfter the procedure, immediate pain relief was achieved and the numbness of both lower limbs disappeared 3 days later. Three months after the procedure, the follow-up magnetic resonance imaging revealed a complete resolution of the hematoma.LessonsOVCF accompanying SEH is fairly rare, and the exact pathophysiological mechanisms are still not clear. In selected patients without or with only slight neurologic symptoms, it is reasonable to perform PVP alone in OVCF accompanying SEH. Moreover, intravertebral stability after PVP might have played a role in spontaneous resolution of SEH.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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