Spontaneous psoas hematoma following posterior lumbar fusion surgery: a mini literature review

• Published in: BMC musculoskeletal disorders Vol. 26; no. 1; pp. 244 - 6
• Main Authors: Zhao, Hai-Hong, Guo, You-Feng, Zhang, Shu-Bao, Harshita-shahi, Xu, Hao-Wei, Yu, Bin, Gu, Hui-Da, Wang, Shan-Jin, Hu, Tao, Wu, De-Sheng
• Format: Journal Article
• Language: English
• Published: London BioMed Central 12.03.2025; BioMed Central Ltd; BMC
• Subjects: Aged; Anticoagulants (Medicine); Case Report; Clopidogrel; Complications and side effects; CT imaging; Epidemiology; Female; Femoral nerve palsy; Femoral Neuropathy - etiology; Hematoma; Hematoma - diagnostic imaging; Hematoma - etiology; Hematoma - therapy; Humans; Internal Medicine; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Medical colleges; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Orthopedics; Patient satisfaction; Physiological aspects; Postoperative Complications - diagnostic imaging; Postoperative Complications - etiology; Psoas hematoma; Psoas Muscles - diagnostic imaging; Rehabilitation; Rheumatology; Risk factors; Spinal fusion; Spinal Fusion - adverse effects; Spinal Stenosis - surgery; Sports Medicine; Surgery; Therapy; Tomography, X-Ray Computed; China; Psoas hematoma; Therapy; Femoral nerve palsy
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-025-08455-9

Background Spontaneous psoas hematoma is a very rare clinical entity, and the pathogenesis and pathologic mechanisms of spontaneous psoas hematoma remain unclear, thus, it is of great value to explore. Case presentation We encountered a patient who developed femoral nerve paralysis due to psoas muscle hematoma following posterior lumbar fusion surgery. A 69-year-old female with lumbar spinal canal stenosis underwent posterior lumbar fusion at the L3-4 and L4-5 levels. On the 7th postoperative day, the patient complained of severe abdominal pain along with right limb pain and weakness. A computed tomography image showed a large acute psoas muscle hematoma on the right side. After conservative treatment, the psoas hematoma was resolved and the patient’s femoral nerve paralysis gradually recovered. Conclusions Spontaneous psoas hematoma is a rare and extremely dangerous complication after lumbar spine surgery. For high - risk patients who have taken anticoagulants before the operation, we must be vigilant against the occurrence of this complication.