A rare case of spontaneous spinal epidural hematoma after kyphoplasty

• A rare case of postoperative spinal epidural hematoma (SEH) following multilevel spinal kyphoplasty was presented. • The patient initially developed postoperative paraplegia, with CT revealing bone cement extrusion but MRI confirming an extensive epidural hematoma from C7–T10. • Emergent T3–T9 laminectomy and hematoma evacuation led to progressive neurological recovery. • Differentiating cement leakage from SEH requires both CT and MRI for accurate diagnosis. • This case emphasizes the importance of early recognition and timely surgical intervention to prevent irreversible neurological deficits. Spinal surgery following by spinal epidural hematoma is a rare condition, the Factors related to symptomatic spinal epidural hematomas include coagulopathy, trauma, surgery, and vascular lesions. Most hematomas occur spontaneously without known etiology, but some spontaneous lesions are related to vascular anomalies [ 1 ].The study showed the higher incidence of hematoma associated with spinal deformity, the location of thoracic spine, posterior approach, and minimally invasive surgery [ 2 ]. We present a case of an obese patient with spinal deformity who underwent multiple spinal surgeries and subsequently developed symptomatic spinal epidural hematomas following kyphoplasty. Early diagnosis via computed tomography scan enabled prompt surgical intervention, minimizing neurological injury.