Rahimizadeh Abolfazl, Soufiani Housain, Rahimizadeh Shaghayegh
Department of Neurospinal Surgery, Pars Advanced.
Minimally Invasive Manners Research Center, Pars Hospital, Tehran, Iran.
Int J Spine Surg. 2016 Oct 17;10:36. doi: 10.14444/3036. eCollection 2016.
Iatrogenic cervical pseudomeningocele is a rare event and majority are located posteriorly as a delayed complication of inadvertent dural tear after decompressive laminectomy. However, iatrogenic anterior cervical pseudomeningocele subsequent to discectomy or corpectomy is a rare pathology. The time necessary for formation of pseudomeningocele varies and depend on the width of the dural tear and the flow of cerebrospinal fluid leakage. Large tears with high CSF flow usually result in early collection of the cerebrospinal fluid in anterior compartment of the neck designated acute pseudomeningoceles. Micro-tears of dura mater, with low flow of cerebrospinal fluid may lead to late formation of a pseudomeningocele known as chronic ones. Herein a 49- year-old woman in whom cervical pseudomeningocele appeared clinically as a mass on the anterior aspect of the neck, six months after anterior cervical corpectomy for cervical spondylotic myelopathy is presented. Otherwise, she was neurologically stable. Cystoperitoneal shunt was proposed which she refused. Surprisingly, at 2-year follow-up, the cyst had remained of the same size. To the best of our knowledge, this is the first example of post-operative chronic cervical pseudomeningocele in the literature, the event that might propose the self-limited natural course of this rare pathology in chronic cases.
医源性颈椎假性脑脊膜膨出是一种罕见的情况，大多数位于后方，是减压性椎板切除术后硬脊膜意外撕裂的延迟并发症。然而，椎间盘切除术或椎体次全切除术后发生的医源性颈椎前路假性脑脊膜膨出是一种罕见的病理情况。假性脑脊膜膨出形成所需的时间各不相同，取决于硬脊膜撕裂的宽度和脑脊液漏出的流量。脑脊液流量高的大撕裂通常会导致脑脊液在颈部前间隙早期积聚，称为急性假性脑脊膜膨出。硬脊膜微撕裂且脑脊液流量低可能导致假性脑脊膜膨出的晚期形成，即慢性假性脑脊膜膨出。本文报道了一名49岁女性，她因脊髓型颈椎病接受颈椎椎体次全切除术后6个月，临床上颈椎假性脑脊膜膨出表现为颈部前方肿块。除此之外，她神经功能稳定。建议行囊肿-腹腔分流术，但她拒绝了。令人惊讶的是，在2年的随访中，囊肿大小保持不变。据我们所知，这是文献中首例术后慢性颈椎假性脑脊膜膨出的病例，该事件可能提示这种罕见病理情况在慢性病例中具有自限性自然病程。
