Large Compressive Pseudomeningocele Causing Early Major Neurologic Deficit After Spinal Surgery
Brandon L Raudenbush1, Andrew Molinari1, Robert W Molinari1
1University of Rochester, Rochester, NY, USA.
Global Spine Journal
|June 30, 2017
Summary
A rare complication of spinal surgery, large compressive pseudomeningocele, can cause major neurologic deficits. Early diagnosis with MRI and emergent surgical repair can lead to improved patient outcomes.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Neurology
Background:
- Large compressive pseudomeningocele is a rare complication following spinal surgery.
- This complication, leading to major neurologic deficits, is not well-documented in medical literature.
Purpose of the Study:
- To investigate the incidence and outcomes of large compressive pseudomeningocele after spinal surgery.
- To highlight the importance of early diagnosis and intervention for this rare complication.
Main Methods:
- Retrospective review of 2552 consecutive extradural spinal surgical cases over a 10-year period.
- Identification of 3 cases of postoperative major neurologic deficits caused by large compressive pseudomeningocele.
Main Results:
- The incidence of postoperative compressive pseudomeningocele causing major neurologic deficit was 0.12%.
- All patients experienced deficits in the early postoperative period and were diagnosed via MRI.
- All patients underwent emergent decompression and dural repair, resulting in neurologic recovery.
Conclusions:
- Incidental durotomy and repair can lead to rare but devastating pseudomeningocele formation.
- Early MRI is crucial for diagnosing compressive pseudomeningocele.
- Prompt surgical intervention (decompression and dural repair) can improve neurologic outcomes.
