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The report describes a 77-year-old male with complex medical history who developed caudal spinal cord injury detected during multimodal IONM, prompting emergent imaging. Identification of spinal epidural hematoma enabled prompt surgical intervention, restoring preoperative neurologic baseline within 24 hours. The conclusion highlights early recognition and timely management of remote neurologic adverse events to reduce morbidity and mortality.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/compressive-spontaneous-spinal-epidural-hematoma-following-cervical-laminoplasty-a-case-report-and-the-role-of-multimodal-neuromonitoring/450885/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/compressive-spontaneous-spinal-epidural-hematoma-following-cervical-laminoplasty-a-case-report-and-the-role-of-multimodal-neuromonitoring/450885.png","ImageObject",300,407,{"name":92,"@type":93},"วิน","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What clinical problem does the report focus on after cervical laminoplasty?","Question",{"text":112,"@type":113},"It focuses on a compressive spontaneous spinal epidural hematoma that occurred following cervical laminoplasty, presenting as a serious neurologic complication.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the neurologic change detected and what did it trigger?",{"text":117,"@type":113},"The neurologic change was detected on intraoperative neuromonitoring, leading to emergent imaging and subsequent identification of spinal epidural hematoma.",{"name":119,"@type":110,"acceptedAnswer":120},"What outcome was achieved after surgical intervention?",{"text":121,"@type":113},"Prompt surgical intervention led to return to the patient’s preoperative neurologic baseline within 24 hours postoperatively.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},450885,1790765760,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},2336475104736,"https://ap-avatar.wpscdn.com/avatar/22000c4c5e0e5b17e70?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786591360781797222","Compressive spontaneous spinal epidural hematoma following cervical laminoplasty and the role of multimodal neuromonitoring:  \na case report  \nMeera M. Dhodapkar1, Mohamed Sarraj 1, Charles A. Mechas 1, E. Matthew Hoffman2, Brian Crum2, Brett A. Freedman1  \n1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; 2Department of Neurology, Mayo Clinic, Rochester, MN, USA Contributions: (I) Conception and design: All authors; (II) Administrative support: BA Freedman, B Crum, EM Hoffman; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript  \nwriting: All authors; (VII) Final approval of manuscript: All authors.  \nCorrespondence to: Brett A. Freedman, MD. Department of Orthopedic Surgery, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.  \nEmail: [freedman.brett@mayo.edu](freedman.brett@mayo.edu).  \nBackground: Cervical myelopathy is a clinical syndrome resulting from cord compression at the level of the cervical spine characterized by fine motor, sphincter, and gait dysfunction, for which early surgical management is the mainstay of therapy. Identification of techniques to monitor for and facilitate early management of rare but serious neurologic complications following cervical spine surgery is of the utmost importance. Intraoperative neuromonitoring (IONM) is one such technique that may be employed to identify neurologic injury in a timely manner including those events occurring remote to the operative levels.  \nCase Description: In this report, we describe the case of a 77-year-old male with a complicated medical history who sustained intraoperative spinal cord injury caudal to the instrumented levels during a cervical laminoplasty. Neurologic change was detected on IONM leading to emergent imaging. Spinal epidural hematoma was identified, which led to prompt surgical intervention resulting in return to preoperative  \nneurologic baseline within 24 hours postoperatively.  \nConclusions: IONM facilitates early identification and allows for prompt management of potential neurologic adverse events including those caudal to operative levels during spine surgery and may reduce or reverse associated morbidity and mortality. We hope this case highlights the importance of further study into  \nthis modality to determine its optimal use in elective spine surgery.  \nKeywords: Cervical spine surgery; epidural hematoma; intraoperative neuromonitoring (IONM); case report  \nSubmitted May 13, 2025. Accepted for publication Aug 15, 2025. Published online Dec 22, 2025.  \ndoi: 10.21037/jss-25-76  \nView this article at: [https://dx.doi.org/10.21037/jss-25-76](https://dx.doi.org/10.21037/jss-25-76)  \nIntroduction  \nCervical myelopathy is the clinical manifestation of cervical spinal cord compression and can result in loss of fine motor control, gait instability, and bowel and bladder symptoms (1) . Early identification and operative intervention in some form is the mainstay of treatment to prevent functional decline and improve neurological prognosis (2-6) .  \nWhile surgical intervention remains the gold standard, particularly in moderate and severe degenerative cervical  \nmyelopathy, it is not without risks (7) . While risks such as dysphagia, pseudoarthrosis, wound complications, and medical complications may be more common, neurologic decline as a complication of surgery can be devastating. Spinal cord injury as a complication of cervical spine surgery is estimated to occur in approximately 5% of cases (8) . Postoperative neurological injury is associated with a significant amount of morbidity and mortality (9), and therefore strategies to identify impending or early  \n© AME Publishing Company. J Spine Surg 2025;11(4):1132-1139 | [https://dx.doi.org/10.21037/jss-25-76](https://dx.doi.org/10.21037/jss-25-76)  \nJournal of Spine Surgery, Vol 11, No 4 December 2025 1133  \nspinal cord injury are of the utmost imp","cbCaipNSxyRGC9Bw","https://ap.wps.com/l/cbCaipNSxyRGC9Bw","pdf",1927813,"English","# Background\n# Case Description\n# Conclusions\n# Introduction\n## Intraoperative neuromonitoring (IONM)\n## Guidelines and high-risk indications\n# Highlight Box","[{\"question\":\"What clinical problem does the report focus on after cervical laminoplasty?\",\"answer\":\"It focuses on a compressive spontaneous spinal epidural hematoma that occurred following cervical laminoplasty, presenting as a serious neurologic complication.\"},{\"question\":\"How was the neurologic change detected and what did it trigger?\",\"answer\":\"The neurologic change was detected on intraoperative neuromonitoring, leading to emergent imaging and subsequent identification of spinal epidural hematoma.\"},{\"question\":\"What outcome was achieved after surgical intervention?\",\"answer\":\"Prompt surgical intervention led to return to the patient’s preoperative neurologic baseline within 24 hours postoperatively.\"}]","Compressive Spontaneous Spinal Epidural Hematoma Following Cervical Laminoplasty - A Case Report - and the Role of Multimodal Neuromonitoring | PDF",1790734039]