Surgical Decompression in a 32-Year-Old Man with Chronic Onset of Thoracic Spontaneous Spinal Epidural Hematoma: A Case Report.

This case report describes a 32-year-old man who experienced worsening chest and back pain along with weakness in both legs. He received acupuncture treatment at a local hospital for over two months, but his symptoms continued to deteriorate rather than improve. When he sought evaluation at another medical facility, imaging studies revealed he had a spontaneous spinal epidural hematoma—a rare condition where blood accumulates in the space around the spinal cord in the thoracic (mid-back) region. This accumulation was compressing his spinal cord and causing progressive neurological problems. The patient required immediate surgical intervention consisting of laminectomy and decompression to remove the pressure on his spinal cord. Within two days after surgery, his chest and back pain completely resolved, and the weakness in his legs significantly improved. He made a full recovery and remained symptom-free during one year of follow-up. This case highlights an important safety consideration for patients: when experiencing progressively worsening back pain, chest pain, or limb weakness, prompt medical evaluation with advanced imaging is essential to rule out serious underlying conditions. While acupuncture can be beneficial for many musculoskeletal conditions, it is not appropriate treatment for spinal cord compression from epidural hematoma, which requires urgent surgical intervention. Delays in proper diagnosis and treatment can result in permanent neurological damage. This case emphasizes the importance of seeking immediate medical attention when symptoms worsen despite conservative treatment. Always seek care from qualified, licensed acupuncture practitioners who can recognize when referral for emergency medical evaluation is necessary.

This case report documents a 32-year-old Asian male who presented with progressive thoracic pain and bilateral lower-extremity weakness that worsened over two months despite acupuncture treatment. MRI revealed thoracic spontaneous spinal epidural hematoma causing spinal cord compression. The patient underwent urgent laminectomy and surgical decompression. Postoperative outcomes were excellent, with complete resolution of pain by day two and significant improvement in motor function. Full neurological recovery was achieved by discharge, with no abnormalities at one-year follow-up. This single-patient case (n=1) demonstrates that neurological recovery correlates directly with timing of surgical intervention and degree of preoperative deficit. Clinical takeaway: Practitioners must maintain high clinical suspicion for spontaneous epidural hematoma in patients presenting with progressive axial pain and neurological deficits, even without trauma or coagulopathy history. Progressive worsening despite conservative care warrants immediate advanced imaging and surgical consultation to prevent irreversible neurological damage.