Spinal subdural hematoma (SDH) is a rare complication after spinal surgery. Only a few cases are reported on spinal SDH following open lumbar spinal decompression or fusion surgery. Moreover, there has been no case report on spinal SDH following percutaneous transforaminal endoscopic lumbar discectomy. We report a case of spinal SDH following endoscopic discectomy, review the literature of this complication and discuss the etiology to it and methods to prevent it. A 63-year-old woman presented with severe radiating pain. Pain was not improved with conservative management. Lumbar magnetic resonance imaging (MRI) was checked and revealed right L3-4 ruptured disc with severe L4 root compression. Percutaneous transforaminal endoscopic decompression was performed and the pain subsided promptly after the endoscopic procedure. On 7th post-operative day, pain on Rt. buttock, anterior thigh was deteriorated severely, more than in pre-operatively. Deteriorated pain was not controlled by oral medications and epidural block. Repeat MRI showed no definite recurrence of disc herniation at decompressed level but spinal SDH, severely compressing cauda equina was seen on T12-sacral area. Spinal SDH is a rare complication following spine surgery, including percutaneous endoscopic surgery. A spine surgeon should be aware of the possibility of spinal subdural hematoma, having severe sequel.

A 45 year-old male was brought to our hospital with severe back pain and motor, sensory impairment in both lower extremities. He had no underlying diseases including coagulapathy. Motor weakness below both hip joint and decreased sensory below T12 dermatome, voiding dysfunction were examined. The MRI showed a spinal subdural hematoma at the thoracolumbar region, which was extremely rare. Medical treatment was applied without surgical interventions. After two weeks, motor weakness, sensory impairment, and voiding dysfunction were improved. And he returned to his daily activities. We present this case and literature reviews because traumatic spinal subdural hematoma is an extremely rare disease and the condition was treated successfully in conservative manner.