Anterior cervical pseudomeningocele causing syncope after spinal surgery: A case report
Reza Ehsanian1, Arshad Ali2, Harminder Singh3
1Division of Physical Medicine and Rehabilitation, Department of Orthopaedics & Rehabilitation, University of New Mexico School of Medicine, Albuquerque, NM, USA.
International Journal of Surgery Case Reports
|January 30, 2022
Summary
A rare complication of spine surgery, incidental durotomy, can cause a pseudomeningocele leading to carotid body compression and syncope. This case highlights the challenges in managing this unique post-surgical complication.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Neurology
Background:
- Incidental durotomy is a known risk during spine surgery.
- Pseudomeningocele formation can occur following dural tears.
- Carotid body (CB) compression can lead to serious neurological symptoms.
Purpose of the Study:
- To report a unique case of anterior cervical pseudomeningocele causing carotid body compression and syncopal episodes.
- To highlight the diagnostic and management challenges of pseudomeningocele after spine surgery.
- To emphasize the potential life-threatening outcomes of untreated dural tears.
Main Methods:
- A patient with ossification of posterior longitudinal ligament (OPLL) underwent anterior and posterior cervical decompression and fusion.
- Post-operatively, the patient developed neck swelling, diagnosed as pseudomeningocele via CT and MRI.
- Management included interventional radiology drainage and subsequent durotomy revision and repair.
Main Results:
- The patient experienced syncopal episodes attributed to carotid body compression by the pseudomeningocele.
- Initial drainage failed to resolve the pseudomeningocele and symptoms.
- Surgical repair of the durotomy was ultimately required.
Conclusions:
- Incidental durotomy in anterior cervical spine surgery can lead to pseudomeningocele formation.
- Pseudomeningocele-induced carotid body compression is a rare cause of postoperative syncope.
- Management of persistent pseudomeningoceles requires careful consideration and often surgical intervention.
