Completely Ossifiying Pseudomeningocele, a Rare Complication after Spinal Surgery

Youssef, Fady; Marković, Dejan; López, Horacio Pérez; Spuler, Andreas; Kiwit, J. C. W.

doi:10.1055/s-0029-1224160

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…However, only seven articles include follow-up (including the addition of our case), so one must take this lack of reports on long-term outcome into account for these patients. The single patient who was not operated remained stable with regard to symptoms for 23 years [20]. It could, therefore, be postulated that a calcified pseudomeningocele on its own probably does not seem to evolve to a larger cyst over time and cause neural compression.…”

Section: Discussionmentioning

confidence: 96%

“…Of the 13 cases reviewed in this article only one case was not operated due to the lack of symptoms from the ossified pseudocyst [20]. All other cases were operated (92 %) with removal of pseudomeningocele and closure of the abnormal communication.…”

Section: Treatmentmentioning

confidence: 99%

“…The first article on the subject was published in 1963 [13]. We found 17 cases described to date by means of a comprehensive computer-based literature search in the PubMed database using the varied nomenclature for calcified pseudomeningoceles as well as reviewing the reference lists of relevant articles [1,3,[5][6][7][9][10][11][12][13][14][15][16][17][18][19][20]. Four of these cases are not reviewed in this article, two of which are in the cervical region, one of which is in Japanese language and one case only known through oral presentation.…”

Section: Introductionmentioning

confidence: 99%

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Calcified pseudomeningocele of the lumbar spine: a review

et al. 2012

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Purpose In this article, we review the English literature of calcified pseudomeningoceles in the lumbar region. Methods A systematic review using the Medline Database using the varied nomenclature for pseudomeningoceles, as well as reviewing the reference lists of relevant article found. Results We discuss the different pathological theories on formation of a pseudomeningocele, the formation of a calcified wall and the optimal management for this entity. To date, 17 cases have been described, of which 13 are reviewed here. Calcification of pseudomeningocele is a rare entity and in the lumbar spine this occurs postsurgically. The only predisposing factor is prior surgery to the lumbar spine. Computer tomography, magnetic resonance imaging (MRI) and MRI myelography in combination are the preoperative investigations of choice. The radiological work-up can be preoperatively diagnostic and is important in the surgical planning. Conclusions The treatment is surgicel removal and the decision to treat is based on patient symptoms and correlating these with imaging. There is an average reported follow-up of 1.7 years postoperatively for these patients and the reported outcome after surgery is good.

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Section: Discussionmentioning

confidence: 96%

Section: Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Calcified pseudomeningocele of the lumbar spine: a review

et al. 2012

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Ossified pseudomeningocele after the removal of an intradural neurinoma in the lumbar spine. A case report and literature review

Евзиков

Bashlachev

Belozerskikh

et al. 2018

Nejrohirurgiâ (Mosk.)

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The study objective is to describe a case of ossified pseudomeningocele after spinal surgery and to develop an optimal treatment strategy for this disorder.Materials and methods. We report a case of ossified pseudomeningocele developed after the removal of an intradural neurinoma in the lumbar spine in a female patient treated in the Clinic for Nervous Diseases, University Clinical Hospital No. 3 of the I.M. Sechenov First Moscow State Medical University in 2017. We also reviewed research literature describing this pathological condition.Results. Upon admission, the patient was diagnosed with paresis of the left foot occurring in ankle joint dorsiflexion (score 4), absence of the Achilles reflex on the left side, and hypoesthesia of two first toes of the left foot. Magnetic resonance imaging revealed a postoperative cyst of irregular shape located in soft tissues at the level of L vertebral body and compressing the dural sac. The patients underwent surgery that included separation of the pseudomeningocele cavity from the dural sac and placement of an external lumbar drainage. In the postoperative period, we observed a complete regression of neurological symptoms.Conclusion. Since ossified pseudomeningocele in the lumbar spine is extremely rare, an optimal treatment strategy has not been developed so far. We believe that maximum possible excision of the cyst wall and anastomotic sealing with a muscular or fat flap with biological glue followed by flap fixation from the extradural space is a simple and robust method of decompression and separation of the anastomosis. To eliminate the cavity in soft tissue of the paravertebral space, we recommend reconstruction of epidural fat with additional sealing using biological glue. To prevent anastomosis recurrence, we recommend placing an external lumbar drainage.

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Completely Ossifiying Pseudomeningocele, a Rare Complication after Spinal Surgery

Abstract: Seven cases of ossified pseudomeningocele have been previously described in the literature and all were operated on. However, our case shows that ossified extradural pseudocysts do not require operation in every case.

Cited by 2 publications

References 6 publications

Calcified pseudomeningocele of the lumbar spine: a review

Calcified pseudomeningocele of the lumbar spine: a review

Ossified pseudomeningocele after the removal of an intradural neurinoma in the lumbar spine. A case report and literature review

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