To analyze the emergency treatment for spontaneous spinal epidural hematoma (SSEH) and propose the countermeasures to improve the status quo.

Eighteen with SSEH who underwent surgery in the Department of Neurosurgery of Union Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology from March 2015 to November 2019 were analyzed retrospectively, and their clinical features, diagnostic methods and procedures, the time interval from neurological dysfunction to surgery and the recovery of neurological function after surgery were summarized.

All the 18 patients had neurological dysfunction at different time after the onset of the disease. The first symptoms were severe pain in 14 cases, neck weakness in 1 case and paraplegia below the chest in 3 cases. All patients finally confirmed intracerebral hemorrhage by MRI, and the time from neurological dysfunction to MRI was 2-120 h, with an average of 43.3 h. After surgical treatment, 15 cases (83.3%) were cured, 2 cases (11.1%) were improved and 1 case (5.6%) was invalid. The longer the time between the onset of neurological dysfunction and surgery, the worse the outcome and the longer the recovery process of neurological function.

Improving the understanding of SSEH among first-diagnosis physicians and timely conduct MRI examination is helpful to early diagnosis and early operation, promote the recovery of neurological function and reduce sequelae.