Entrapped spinal nerve roots in a pseudomeningocoele as a complication of previous spinal surgery

Abstract

Pseudomeningocele is a rare but well recognised complication of lumbar surgery (microdiscectomy and laminectomy). Most of the patients tolerate the presence of the cyst well, however some present with back pain and spinal claudication, presumably due to neural compression. We report a case who presented following three operations (microdiscectomy, laminectomy and excision of a pseudomeningocele) with symptoms of spinal claudication and bilateral radicular pain. The cause of her pain was evident only at operation and was due to herniation of nerve roots through the dural defect.

Transdural radicular herniation without pseudomeningocele after spinal stenosis surgery: the electric eel sign

“…More recently, O'Connor et al [6] and Kothbauer and Seiler [7] reported similar cases after microdiscectomy and laminectomy, or after multiple surgeries [8], now diagnosed by MRI, and treated surgically. Töppich et al [9] reported after microdiscectomy, a case of extensive pseudomeningocele through which the nerve root herniated into the intersomatic space.…”

Lumbar Pseudomeningocele Causing Hydronephrosis

“…Usually the origin of the fluid is obvious, but when unclear, the presence of b-2 transferrin establishes the fluid as spinal fluid (15). The types of spinal interventions that have been associated with pseudomeningoceles range from simple lumbar puncture to complex anterior and posterior operations (2,3,(6)(7)(8)(9)(10)(11)(12). The presence of a pseudomengocele anterior to the spine and causing ureteral obstruction is distinctly rare, and we could find no similar case in the literature.…”

Clinical and Radiological Findings of Nerve Root Herniation after Discectomy of Lumbar Disc Herniation

“…Incidental dural tears do not adversely influence the long-term prognosis if they are properly repaired3-5). In addition to nerve root herniation, unrepaired dural tears can lead to pseudomeningocele formation, persistent CSF leakage, meningitis, or arachnoiditis7,11). Ahn et al1) pointed out that unrecognized dural tears follow complex clinical courses because delayed widening of the dural opening by CSF pressure can cause significant neural entrapment, which cannot easily be detected.…”