Conservative management of spontaneous
thoracolumbar epidural hematoma: a case
report

Conservative management of spontaneous
thoracolumbar epidural hematoma: a case
report

Spontaneous spinal epidural hematoma, Spontaneous absorption, Non-surgical treatment

Abstract
Background Spontaneous spinal epidural hematoma (SSEH) is an exceedingly rare clinical entity often associated
with neurological deficits, for which surgical intervention remains the mainstay of treatment. We report a case
successfully managed through complete conservative therapy.
Case presentation A 59-year-old Chinese male with a medical history of hypertension, chronic smoking, and alcohol
use presented to our institution with acute-onset low back pain accompanied by bilateral lower limb weakness and
hypoesthesia persisting for 30 min. Diagnostic imaging (CT and MRI) revealed a thoracolumbar epidural hematoma
(T11-L1 distribution). Contrary to conventional surgical management paradigms, we implemented a comprehensive
conservative management protocol. Remarkably, complete resolution of symptoms and spontaneous hematoma
absorption were achieved within 20 days.
Conclusion This case demonstrates that select SSEH cases may achieve favorable outcomes through conservative
management without surgical decompression.
Keywords Spontaneous spinal epidural hematoma, Spontaneous absorption, Non-surgical treatment

Menglong Jia1,2†, Shan Gao1†, Longtan Yu1

and Guangbin Ma1*

https://doi.org/10.1186/s12245-025-01105-w

2026

peri irawan

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