Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2006 Jun;13(2):132-137. Korean.
    Published online Jun 30, 2006.
    https://doi.org/10.4184/jkss.2006.13.2.132
    Copyright © 2006 Korean Society of Spine Surgery
    Case Report

    Pseudomeningocele After Spine Surgery -3 cases of different symptoms-

    Byoung Ki Kwon, M.D., Dong Ki Ahn, M.D., Ki Woong Jeong, M.D. and Kwan Young Park, M.D.
      • Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea.
    • Address reprint requests to: Dong Ki Ahn, M.D. Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital 40-12 Chungryangri-dong, Dongdaemoon-gu, Seoul. Tel: 82-2-966-1616, Fax: 82-2-968-2394, Email: adkajs@hanmail.net

    Abstract

    Pseudomeningocele after spine surgery can cause various symptoms, but it can also be silent. We experienced 3 cases of pseudomeningocele with different symptoms and we analyzed the characteristics of each case. A small pseudomeningocele without connection to the subarachnoidal space can show no symptoms. A pseudomeningocele with a small dural tear and it's abutted on the duramater at a small portion can produce sciatica and limitations of straight leg raising due to adhesion of the cauda equina around the dural tear. In addition, a large pseudomeningocele with a big dural and lamina defect can produce back tenderness furthermore, a patient with such a lesion can have low back pain and leg pain that are aggravated by an increment of abdominal pressure or by impact to the body and even by walking. Pseudomeningocele should be suspected when symptoms recur after spine surgery and especially in the case of dural tear during an operation.

    Keywords
    pseudomeningocele; spine surgery

    Figures

    Fig. 1
    These are images of 55 year old female patient who underwent multiple schwanommas excision at T11, L3 and PLIF L4-5 for spondylolytic spondylolisthesis. (A) Sagittal MR T2 weighted image which shows large well marginated cyst in size of 160×50 mm connected to subarachnoid space(arrow). (B) Intraoperative finding shows dural defect. Through the defect, inflamed cauda equina are seen and some of them are adhesed to the margin. (C) Intraoperative finding shows fascia lata graft covering the dural defect. (D) Sagittal MR T2 weighted image at 24 months after dural repair which shows complete obliteration of the cyst.

    Fig. 2
    This is a sagittal MR T2 weighted image of 60 year old female patient who underwent PLF L4-5 which shows 60×25 mm sized cyst that seems to be connected to subarachnoid space.

    Fig. 3
    This is a sagittal MR T2 weighted image of 67 year old male patient who underwent PLF L3-4-5 which shows 40×25 mm sized cyst that seems not to be connected to subarachnoid space.

    References

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    MeSH Terms
    Cauda Equina
    Humans
    Leg
    Low Back Pain
    Sciatica
    Spine*
    Walking
    Metrics
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