A Case Report on the Treatment of Lumbar Spontaneous Spinal Epidural Hematoma Using Unilateral Biportal Endoscopy

Background : Spontaneous spinal epidural hematoma(SSEH)is a rare condition that can result in severe neurological deficits, often accompanied by back pain. Due to its atypical presentation and imaging features that mimic other diseases, early diagnosis of SSEH remains challenging. This case report provides an example of such a scenario. Case Presentation : A 70-year-old female was admitted with complaints of "low back pain accompanied by left leg pain and restricted mobility for more than 20 days. "Imaging suggested a left-sided L3 intraspinal lesion compressing the L3 nerve. The patient underwent unilateral biportal endoscopy(UBE)for spinal canal decompression and lesion removal. During surgery, dark, chronic clotted blood was identified on the lateral side of the dura mater. Postoperatively, the patient recovered well. Conclusion : This report highlights the possibility of spontaneous spinal epidural hematoma in patients without risk factors and describes a rare imaging presentation. The patient achieved a favorable outcome following treatment with unilateral biportal endoscopy.