Pseudomeningocele after Anterior Cervical Discectomy and Fusion: Case Report

Background: Pseudomeningocele secondary to dural tear during anterior cervical discectomy and fusion (ACDF) occurs extremely rarely. Few cases of pseudomeningocele after ACDF requiring direct surgical repair have been described.

Aim: We report an unusual case of pseudomeningocele in a patient who underwent ACDF for a cervical disc prolapse. A discussion about therapeutic options and possible secondary complications is also provided.

Study Design: Case report

Results: A 51-year-old woman who recently undergone C5-C6 ACDF complicated by dural tear, presented 5 days following the operation with tender and tense swelling underlying the cervical wound. Magnetic resonance imaging scan of the cervical spine showed a large fluid collection in the right anterior neck, communicating with the spinal canal at the level of the C5--C6 discectomy. She underwent evacuation of the pseudomeningocele, surgical repair of the dural tear and insertion of a lumbar drain. Postrepair at 2 months, she remained asymptomatic and neurologically intact.

Conclusion: Pseudomeningocele following dural tear and cerebrospinal fluid (CSF) leak during anterior cervical discectomies is a rare complication but its prompt identification is mandatory for the good outcome and the prevention of potential secondary complications. Cases of symptomatic pseudomeningoceles can be managed with direct repair and transient CSF diversion with successful results.

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