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Giant lumbar pseudomeningocele after revision lumbar laminectomy: a case report and review of the literature.


ABSTRACT:

Introduction

Incidental durotomy is a relatively common complication of spine surgery. Prevalence ranges from 3 to 5% in primary and 7 to 17% in revision procedures. Despite this relatively common occurrence the subsequent development of pseudomeningoceles following lumbar spine surgery is reported to be between 0.07 and 2%. Giant pseudomeningoceles (GP) are rare and therefore we report our experience with a case.

Case presentation

We report a case of an iatrogenic GP post revision lumbar surgery that extended 19?cm in length. The patient underwent revision L3-S1 laminectomy, laminotomy, excision of pseudomeningocele and successful direct dura repair. Postoperatively, a subcutaneous seroma persisted. This was managed with surgical exploration and prolonged drainage. This led to reduction of the seroma and symptomatic improvement for the patient.

Discussion

Incidental durotomy is a relatively common complication of spine surgery and if the durotomy is not addressed at the time of an operation a pseudomeningocele may develop. A pragmatic approach for GP is to individualise management based upon symptoms. Although GP are rare, prevention is likely the best approach. We outlined a structured approach to the management of an incidental dural leak that formed the largest reported pseudomeningocele reported to date.

SUBMITTER: Enke O 

PROVIDER: S-EPMC6131479 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Giant lumbar pseudomeningocele after revision lumbar laminectomy: a case report and review of the literature.

Enke Oliver O   Dannaway Jasan J   Tait Matthew M   New Charles H CH  

Spinal cord series and cases 20180910


<h4>Introduction</h4>Incidental durotomy is a relatively common complication of spine surgery. Prevalence ranges from 3 to 5% in primary and 7 to 17% in revision procedures. Despite this relatively common occurrence the subsequent development of pseudomeningoceles following lumbar spine surgery is reported to be between 0.07 and 2%. Giant pseudomeningoceles (GP) are rare and therefore we report our experience with a case.<h4>Case presentation</h4>We report a case of an iatrogenic GP post revisio  ...[more]

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