Conservative management of a cervical hematoma after anterior cervical discectomy and fusion: A case report

Abstract

Introduction and importance

With an incidence ranging from 0.4 % to 2.4 %, post-operative hematoma after anterior cervical discectomy and fusion (ACDF) is considered as potentially fatal since it can rapidly lead to acute airway obstruction and respiratory failure.

Case report

A 31-year-old male patient underwent a 2-level ACDF. On postoperative day 2, the patient developed thoracic pain and dysphagia. Imaging revealed a cervical hematoma without airway compromise or other critical symptoms. Conservative management was initiated with corticosteroids and close monitoring. Over the next several days, the hematoma reduced in size, and the patient recovered without requiring surgical intervention.

Clinical discussion

Hematoma formation after ACDF is rare but can be life-threatening due to potential airway compromise, often necessitating reoperation. While the patient had a large hematoma, conservative management was chosen due to a patent airway, normal vitals, and symptom resolution after 8 h, avoiding the risks of surgery.

Conclusion

This case highlights that with careful patient selection, including stable vital signs, patent airway, and favorable response to steroids, conservative management may avoid the morbidity of reoperation.