{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:03:13Z","timestamp":1789995793710,"version":"4.0.1"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This study systematically reviews the incidence, types, and management of intracranial hemorrhage (ICH) following major and minor spinal procedures, highlighting demographic trends, risk factors, and treatment outcomes to standardize clinical practices and improve patient safety. ICH following spine procedures, both major and minimally invasive, remains a rare but severe complication. The exact etiological factors are yet to be fully identified, though cerebrospinal fluid (CSF) leakage and decreased intracranial pressure are significant contributors. A comprehensive literature search identified 114 studies reporting ICH cases from minor post-spinal procedures. A total of 138 patients were included. Data were extracted on demographics, types of spinal procedures, ICH, and management strategies. A database from a previously published paper, which included 109 patients postmajor spinal procedures, was incorporated for comparative analysis to identify patterns and differences. Our study analyzed 138 cases of ICH following minimally invasive spinal procedures, compared to 109 postmajor cases. Females predominated in the minimally invasive group (88.7%). Subdural hematoma was significantly higher in minor procedures (90%), while cerebellar hemorrhage occurred only in major procedures (56.9%). Needle sizes varied, with 18 Gauge needles used in 17% of cases and 66.1% reported as \u201cOthers.\u201d Mortality rates were comparable between major (3.7%) and minor (5.7%) procedures, indicating similar risk levels. ICH following spinal procedures, particularly minor ones, presents a significant clinical challenge. The findings underscore the need for customized treatment strategies and vigilant monitoring, especially in younger, healthier populations. Study limitations include potential publication bias and heterogeneity, highlighting the need for further research with more extensive, diverse samples to validate these findings.<\/jats:p>","DOI":"10.4103\/jcvjs.jcvjs_70_26","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T17:00:43Z","timestamp":1789750843000},"page":"464-472","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Intracranial hemorrhage following spinal interventions: A comparison between major surgical procedures versus minimally invasive procedures"],"prefix":"10.4103","volume":"17","author":[{"given":"Yahya","family":"Al-Kindi","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Medical City for Military and Security Services, Muscat, Sultanate of Oman"},{"name":"Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Al-Balushi","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Al-Yaqadhan","family":"Al-Kindi","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firas","family":"Al Rashdi","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman"},{"name":"Department of Orthopedic Surgery, Oman Medical Specialty Board, Muscat, Sultanate of Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq","family":"Al-Saadi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Khoula Hospital, Muscat, Sultanate of Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"R1-20260921","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1227\/00006123-198108000-00016","article-title":"Cerebellar hemorrhage complicating cervical laminectomy","volume":"9","author":"Chadduck","year":"1981","journal-title":"Neurosurgery"},{"key":"R2-20260921","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1186\/s12891-015-0743-7","article-title":"Perioperative stroke in patients undergoing elective spinal surgery: A retrospective analysis using the Japanese diagnosis procedure combination database","volume":"16","author":"Ohya","year":"2015","journal-title":"BMC Musculoskelet Disord"},{"key":"R3-20260921","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.21037\/atm-22-4929","article-title":"Intracranial hemorrhage after spinal surgery: A literature review","volume":"10","author":"Huang","year":"2022","journal-title":"Ann Transl Med"},{"key":"R5-20260921","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s10072-009-0103-1","article-title":"Intracranial and intraspinal hemorrhage following spinal anesthesia","volume":"30","author":"Rocchi","year":"2009","journal-title":"Neurol Sci"},{"key":"R6-20260921","doi-asserted-by":"crossref","first-page":"e98","DOI":"10.1055\/s-0042-1743525","article-title":"Intracranial hemorrhage following spinal surgery: A systematic review of a rare complication","volume":"8","author":"Al-Saadi","year":"2022","journal-title":"Surg J (N Y)"},{"issue":"1","key":"R7-20260921","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/S0034-7094(12)70107-1","article-title":"Intracranial subdural hematoma: A rare complication following spinal anesthesia: Case report","volume":"62","author":"Bisinotto","year":"2012","journal-title":"Rev Bras Anestesiol"},{"key":"R8-20260921","first-page":"15","article-title":"Conversion rate of epidural analgesia to caesarean section regional or general anesthesia","volume":"61","author":"\u0160klebar","year":"2022","journal-title":"Acta Clin Croat"},{"key":"R9-20260921","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1586\/14737175.8.3.385","article-title":"Managing headache during pregnancy and lactation","volume":"8","author":"Marcus","year":"2008","journal-title":"Expert Rev Neurother"},{"key":"R10-20260921","first-page":"229","article-title":"Epidemiology of complications of obstetrical epidural analgesia","volume":"42","author":"Palot","year":"1994","journal-title":"Cah Anesthesiol"},{"key":"R11-20260921","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1001\/jamaneurol.2020.1512","article-title":"Assessment of incidence and risk factors of intracerebral hemorrhage among participants in the framingham heart study between 1948 and 2016","volume":"77","author":"Lioutas","year":"2020","journal-title":"JAMA Neurol"},{"key":"R12-20260921","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/S0034-7094(10)70077-5","article-title":"Intracranial subdural hematoma post-spinal anesthesia: Report of two cases and review of 33 cases in the literature","volume":"60","author":"Amorim","year":"2010","journal-title":"Rev Bras Anestesiol"},{"key":"R13-20260921","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.ijoa.2005.07.001","article-title":"Does postdural puncture headache left untreated lead to subdural hematoma? Case report and review of the literature","volume":"15","author":"Zeidan","year":"2006","journal-title":"Int J Obstet Anesth"},{"key":"R14-20260921","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.ijoa.2015.09.003","article-title":"Intracranial subdural haematoma following neuraxial anaesthesia in the obstetric population: A literature review with analysis of 56 reported cases","volume":"25","author":"Cuypers","year":"2016","journal-title":"Int J Obstet Anesth"},{"key":"R15-20260921","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1093\/bja\/64.5.537","article-title":"Serious non-fatal complications associated with extradural block in obstetric practice","volume":"64","author":"Scott","year":"1990","journal-title":"Br J Anaesth"},{"key":"R16-20260921","first-page":"395","article-title":"Intracranial subdural hematoma following dural puncture","volume":"56","author":"Nakanuno","year":"2007","journal-title":"Masui"},{"key":"R17-20260921","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1093\/bja\/86.6.893","article-title":"Cranial subdural haematoma after spinal anaesthesia","volume":"86","author":"Acharya","year":"2001","journal-title":"Br J Anaesth"},{"key":"R18-20260921","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1136\/jnnp.54.5.440","article-title":"Changes in intracranial CSF volume after lumbar puncture and their relationship to post-LP headache","volume":"54","author":"Grant","year":"1991","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R20-20260921","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.3171\/2013.7.JNS13484","article-title":"Overdrainage shunt complications in idiopathic normal-pressure hydrocephalus and lumbar puncture opening pressure","volume":"119","author":"Khan","year":"2013","journal-title":"J Neurosurg"}],"container-title":["Journal of Craniovertebral Junction and Spine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_70_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:11:50Z","timestamp":1789992710000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_70_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jcvjs.jcvjs_70_26","relation":{},"ISSN":["0974-8237","0976-9285"],"issn-type":[{"value":"0974-8237","type":"print"},{"value":"0976-9285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-03-17","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-26","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}