Management of giant pseudomeningoceles after spinal surgery

BMC Musculoskelet Disord. 2010 Mar 21:11:53. doi: 10.1186/1471-2474-11-53.

Abstract

Background: Pseudomeningoceles are a rare complication after spinal surgery, and studies on these complex formations are few.

Methods: Between October 2000 and March 2008, 11 patients who developed symptomatic pseudomeningoceles after spinal surgery were recruited. In this retrospective study, we reported our experiences in the management of these complex, symptomatic pseudomeningoceles after spinal surgery. A giant pseudomeningocele was defined as a pseudomeningocele >8 cm in length. We also evaluated the risk factors for the formation of giant pseudomeningoceles.

Results: All patients were treated successfully with a combined treatment protocol of open revision surgery for extirpation of the pseudomeningoceles, repair of dural tears, and implantation of a subarachnoid catheter for drainage. Surgery-related complications were not observed. Recurrence of pseudomeningocele was not observed for any patient at a mean follow-up of 16.5 months. This result was confirmed by magnetic resonance imaging.

Conclusions: We conclude that a combined treatment protocol involving open revision surgery for extirpation of pseudomeningoceles, repair of dural tears, and implantation of a subarachnoid catheter for drainage is safe and effective to treat giant pseudomeningoceles.

MeSH terms

  • Adult
  • Aged
  • Arachnoid / pathology
  • Arachnoid / physiopathology
  • Catheterization
  • Cerebrospinal Fluid Pressure
  • Diskectomy / adverse effects
  • Dura Mater / injuries*
  • Dura Mater / pathology
  • Dura Mater / surgery*
  • Female
  • Humans
  • Laminectomy / adverse effects
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / physiopathology
  • Lumbar Vertebrae / surgery
  • Male
  • Meningocele / etiology
  • Meningocele / physiopathology
  • Meningocele / surgery*
  • Middle Aged
  • Neurosurgical Procedures / adverse effects*
  • Plastic Surgery Procedures / methods
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / surgery*
  • Reoperation / methods
  • Retrospective Studies
  • Risk Factors
  • Spinal Canal / anatomy & histology
  • Spinal Canal / surgery
  • Spine / pathology
  • Spine / physiopathology
  • Spine / surgery*
  • Suction
  • Treatment Outcome
  • Young Adult