THE NATURAL RESOLUTION OF A LUMBAR SPONTANEOUS EPIDURAL HEMATOMA AND ASSOCIATED RADICULOPATHY

This is a report of a 37-year-old man who, while lifting a heavy box, developed severe low-back pain radiating into the right anterior thigh . The only clinical signs were paraspinal muscle spasm and a positive femoral nerve stretch test on the right. An electromyographic study de monstrated denervation in the right L2, L3, and L4 myotomes and parasp inal muscles. Magnetic resonance imaging (MRI) showed a large L1-2 ant erior epidural hematoma compressing the spinal cord. The patient's pai n gradually improved with conservative management and he returned to l ight work after 4 weeks. Repeat electromyographic and MRI studies were normal, indicating a resolution of the radiculopathy and hematoma. Th e diagnosis and management of spontaneous epidural hematomas are discu ssed.