Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9686-9690
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9686
Iatrogenic giant pseudomeningocele of the cervical spine: A case report
Koh-Woon Kim, Jae-Heung Cho
Koh-Woon Kim, Jae-Heung Cho, Department of Korean Medicine Rehabilitation, College of Korean Medicine, Kyung Hee University, Seoul 02447, South Korea
Author contributions: Cho JH was the patient’s doctor of Korean medicine, reviewed the literature and contributed to manuscript drafting; Kim KW analyzed and interpreted the imaging findings and was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jae-Heung Cho, MD, PhD, Associate Professor, Department of Korean Medicine Rehabilitation, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, South Korea. vetkong95@hanmail.net
Received: June 28, 2021
Peer-review started: June 28, 2021
First decision: July 26, 2021
Revised: July 27, 2021
Accepted: September 19, 2021
Article in press: September 19, 2021
Published online: November 6, 2021
Abstract
BACKGROUND

Only a few cases of giant pseudomeningoceles have been reported in the literature. Herein, we report a giant pseudomeningocele of the cervical spine that was found after cervical laminectomy for an epidural hematoma following epidural blockade.

CASE SUMMARY

A 47-year-old man presented with recurrent neck pain and posterior neck swelling after spinal surgery. Magnetic resonance imaging of the cervical spine revealed fluid collection (5.6 cm × 6.6 cm × 11.2 cm) at the C3-6 level; this proved to be a pseudomeningocele. Symptoms related to the pseudomeningocele resolved following dural repair and fat graft transplantation.

CONCLUSION

Although rare, pseudomeningocele is a possibility in patients with recurrent back pain, radicular pain, or a persistent headache following spinal surgery. Continuous attention should be paid throughout the spinal procedure, whether conservative or non-conservative.

Keywords: Iatrogenic spinal pseudomeningocele, Giant pseudomeningocele, Cervical spine, C3-6 level, Cervical laminectomy, Case report

Core Tip: Only a few cases of giant pseudomeningoceles have been reported in the literature. Here we present a rare case of a giant pseudomeningocele of the cervical spine identified after cervical laminectomy for an epidural hematoma after epidural blockade. The patient presented with recurrent neck pain and posterior neck swelling after spinal surgery. Magnetic resonance imaging of the cervical spine revealed fluid collection at the C3-6 level that proved to be a pseudomeningocele. This case highlights that, despite its rarity, giant pseudomeningocele must be taken in consideration in patients who report recurrent back pain, radicular pain, or a persistent headache after spinal surgery.