Postoperative symptomatic spinal epidural hematoma (PSSEH) is a serious complication of spinal surgery that is associated with significant morbidity. Studies suggest that hypertension is a risk factor for the development of PSSEH. The aim of this review was to evaluate the literature reporting associations between hypertension and PSSEH. A comprehensive literature search was conducted using the MEDLINE/PubMed, Embase, and Cochrane Library databases to identify studies that investigated PSSEH and reported data on preoperative hypertension status and/or perioperative blood pressure (BP). Eighteen studies were identified for inclusion in the review. Observational data suggested that uncontrolled/untreated preoperative hypertension, extubation-related increases in systolic BP, and elevated postoperative systolic BP were associated with an increased risk of PSSEH. The overall quality of evidence was low because of the retrospective nature of the studies, heterogeneity, and lack of precision in reporting. Despite the limitations of the current evidence, our findings could be important in establishing preoperative BP targets for elective spine surgery and inform perioperative clinical decision-making, while allowing consideration of risk factors for PSSEH. Well-controlled studies are required to investigate further the relationship between BP and PSSEH.

中文翻译：

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全身性高血压和术后症状性脊髓硬膜外血肿：范围审查。

术后症状性脊髓硬膜外血肿（PSSEH）是脊柱手术的一种严重并发症，与显着的发病率相关。研究表明高血压是 PSSEH 发生的危险因素。本综述的目的是评估报告高血压与 PSSEH 之间关联的文献。使用 MEDLINE/PubMed、Embase 和 Cochrane 图书馆数据库进行了全面的文献检索，以确定调查 PSSEH 并报告术前高血压状态和/或围手术期血压 (BP) 数据的研究。确定了十八项研究纳入审查。观察数据表明，未控制/未治疗的术前高血压、拔管相关的收缩压升高以及术后收缩压升高与 PSSEH 风险增加相关。由于研究的回顾性、异质性以及报告缺乏准确性，证据的总体质量较低。尽管目前证据有限，但我们的研究结果对于确定择期脊柱手术的术前血压目标并为围手术期临床决策提供信息可能很重要，同时允许考虑 PSSEH 的危险因素。需要良好对照的研究来进一步研究 BP 和 PSSEH 之间的关系。