Cervical pseudomeningocele following posterior cervical spine surgery a cause of neurologic deterioration

Abstract

Cervical pseudomeningocele causing late onset neurological deterioration is a rare entity. We report our experience with surgical management of a patient with symptomatic cervical pseudomeningocele. A 49-year-old man who underwent posterior cervical laminectomy for cervical ossified posterior longitudinal ligament had neurological deterioration 7 years after undergoing surgery. On evaluation, magnetic resonance imaging of the cervical spine showed cervical pseudomeningocele extending from C2-C6 level causing cord compression at C2-C7 levels. He underwent C2, C7 laminectomy and excision of pseudomeningocele and closure of the communication with dural tube. The post-operative course was uneventful. We present this rare case specially emphasizing the pathogenesis, clinical features and management issues concerning late onset pseudomeningocele. Awareness of this rare possibility of late onset neurological deterioration from posterior cervical pseudomeningocele and its treatment options can help in early diagnosis and treatment.

Keywords

• Pseudomeningocele
• Dural tear
• Complication
• Laminectomy
• Cerebrospinal fluid