Postoperative spinal cord herniation with pseudomeningocele in the cervical spine: a case report

BACKGROUND CONTEXT: Postoperative spinal cord herniation with pseudomeningocele is a rare disease, with only five cases reported before the present study. PURPOSE: To describe the clinical features and radiologic findings of postoperative spinal cord herniation with pseudomeningocele. STUDY DESIGN: Case report. METHODS: A case of a 51-year-old man who suffered from postoperative spinal cord herniation with pseudomeningocele was reported, and previous reports on this subject are reviewed. RESULTS: He had undergone excision of a spinal cord tumor in the cervical spine 10 years previously. He had progressive paraparesis and urinary disturbance 10 years later. The Computed Tomography Multi Planner Reconstruction myelogram showed dilation of the ventral subarachnoid space with left deviation of the spinal cord into the pseudomeningocele at C7. On observation at surgery, the spinal cord appeared displaced dorsally and herniated through the defect of the dorsal dura mater. The spinal cord was tightly adhesive around the dural defect. We released the adhesion of the spinal cord and the dural defect under the spinal cord, and the dural defect was repaired using an artificial dura mater. CONCLUSIONS: The release of adhesion around dural defect and repair of dural defect under spinal cord monitoring resulted in a satisfactory neurologic recovery. Surgical repair of the dural defect with a dural substitute was necessary. (C) 2013 Published by Elsevier Inc.