Conservative Management for Spontaneous Lumbar Facet Joint Hemarthrosis in Severe Hemophilia a: A Rare Case Report

Chia‑Ying Lai ； Yeu‑Chin Chen ； Tsung‑Ying Li

《Journal of Medical Sciences》 43卷1期 (2023/02) Pp. 37-39

https://doi.org/10.4103/jmedsci.jmedsci_281_21

摘要

Spontaneous lumbar facet joint bleeding is rarely observed in patients with hemophilia. Since it is categorized as a spinal epidural hematoma, surgery is the main treatment. Conservative treatment was successful in patients with minor or absent neurological deficits. We aimed to present the case of a patient with severe hemophilia who suffered from acute sciatica caused by lumbar facet joint hematoma. Nonsurgical treatment using a multidimensional approach was provided. The hemarthrosis is completely resolved. The patient recovered from clinical neurological symptoms without recurrence throughout the 4‑year follow‑up period. Spontaneous lumbar facet joint hemarthrosis in patients with severe hemophilia who present with mild neurological symptoms can be conservatively treated if the hemarthrosis is recognized early. Moreover, a multidisciplinary team approach is paramount in achieving good patient outcomes.

關鍵字

Hemophilia A ； spontaneous lumbar facet joint hemarthrosis ； conservative treatment