Abstract
This paper reports a case of postoperative pseudomeningocele, which was not diagnosed initially with clinical data alone; the condition was caused by an inadvertent meningeal tear that occurred during spinal surgery. Pseudomeningocele formation is a rare postoperative complication of spinal surgery characterized by the extradural accumulation of cerebrospinal fluid following extravasation through an inadvertent dural tear. A 69-year-old woman had undergone laminectomy and posterolateral fusion at the L3-L5 level 7 years previously, for spondylolisthesis with spinal stenosis syndrome; the postoperative course was uneventful. Six years after the surgery, the patient experienced increasingly severe low back pain radiating to both gluteal regions. After prolonged but unresponsive conservative treatment, a large pseudomeningocele at the L2-L3 level was identified by myelography. The findings of MRI supported the diagnosis of pseudomeningocele. Surgery via the posterior approach exposed the pseudomeningocele after a complete laminectomy of L2-L4. The pseudomeningocele was excised 7 years after the initial operation. Complete recovery and excellent remission of symptoms was noted at 6 months after the surgery. Pseudomeningocele must always be considered as a cause of chronic back pain in patients who have undergone previous lumbar surgery, no matter how many years after the surgical procedure the symptoms may occur.
Published Version
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