• Jinhua Lin, Xiaofeng Lai, Rui Zhu, and Hao Wu.
• Department of Orthopaedics, First Affiliated Hospital of Jinan University, Tianhe District, Guangzhou City, Guangdong Province, China.
• Medicine (Baltimore). 2023 Jul 28; 102 (30): e34136e34136.

RationaleThalassemia combined with extramedullary hematopoietic spinal cord compression is extremely rare; its ideal treatment is still controversial. Herein, we present 2 cases of thalassemia combined with extramedullary hematopoietic compression of the spinal cord wherein satisfactory results were obtained using unilateral bi-portal endoscopy (UBE).Patient ConcernsCase 1 was of a 43-year-old male who presented with a chief complaint of numbness of the left lower limb since 1-month. Case 2 involved a 23-year-old male who was admitted to the hospital with a chief complaint of numbness in both toes since 3 months and walking instability since 2 weeks. Both cases had a history of being diagnosed with thalassemia.DiagnosesComputed tomography and magnetic resonance imaging showed spinal canal space-occupying lesions causing dural compression and spinal stenosis. Postoperative pathology confirmed the spinal canal lesions to be extramedullary hematopoietic tissue.InterventionsFor spinal canal decompression, UBE supplemented by blood transfusion was performed for both cases.OutcomesAll preoperative symptoms were relieved postoperatively; no recurrence was noted at the 6-month follow-up.LessonsThalassemia combined with extramedullary hematopoiesis can lead to acute spinal cord compression. UBE significantly relieves spinal stenosis symptoms; furthermore, UBE combined with blood transfusion for spinal canal extramedullary hematopoiesis gives satisfactory results, is safe, and has a low risk of spinal cord injury.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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