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Pseudomeningocele after Lumbar Discectomy

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We report a case of postlaminectomy pseudomeningocele which treated successfully by surgical removal with fat graft. A 23-year-old man complained of low back pain and right leg pain and a soft mass in the back at the site of the incision. Four months earlier, he had undergone surgery for herniated nucleus pulposus on L4-L5 segment and three times revision surgery for CSF leakage. A magnetic resonance imaging(MRI) study revealed a large cystic formation in the low back which communicated with a laminectomy site. At surgery, the pseudomeningocele was exposed subcutaneously and explored inside without further laminectomy. A dural tear was identified just around the nerve root with some suture materials and there was persistent CSF leaks. The dura was closed with interrupted sutures. Then we performed sandwich-typed fat graft with glue. Postoperatively, his leg pain was relieved completely and the wound was healed satisfactory without palpable back mass.

Abstract

We report a case of postlaminectomy pseudomeningocele which treated successfully by surgical removal with fat graft. A 23-year-old man complained of low back pain and right leg pain and a soft mass in the back at the site of the incision. Four months earlier, he had undergone surgery for herniated nucleus pulposus on L4-L5 segment and three times revision surgery for CSF leakage. A magnetic resonance imaging(MRI) study revealed a large cystic formation in the low back which communicated with a laminectomy site. At surgery, the pseudomeningocele was exposed subcutaneously and explored inside without further laminectomy. A dural tear was identified just around the nerve root with some suture materials and there was persistent CSF leaks. The dura was closed with interrupted sutures. Then we performed sandwich-typed fat graft with glue. Postoperatively, his leg pain was relieved completely and the wound was healed satisfactory without palpable back mass.

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