Institut Parisien du Dos, Clinique Geoffroy-Saint-Hilaire, 59, rue Geoffroy-Saint-Hilaire, 75005 Paris, France.
Pan Afr Med J. 2022 Aug 8;42:257. doi: 10.11604/pamj.2022.42.257.35812. eCollection 2022.
Anterior dural tears complicated by cerebrospinal fluid (CSF) leakage with anterior meningocele are rare. Indeed, in the literature, cases are described during anterior arthrodesis, but no cases of post-cervical arthroplasty are described. The management of this type of complication is poorly described and not consensual. We present a case of a patient who underwent cervical arthroplasty complicated by an anterior meningocele at 1 month after the first surgery. Imaging revealed a compressive anterior meningocele in relation to the clinically progressive worsening. Revision surgery consisted of a combination of closure of the gap with a fatty patch covered with a TachoSil patch, followed by reinsertion of a new cervical prosthesis. At the last follow-up at 1 year, the patient showed no residual effects of the complication, and the mobility of the disc prosthesis was not impaired by it. Clinical results of the arthroplasty are also very satisfactory. Although these types of complications are rare, it is important to have a consensus on the management of anterior meningocele. In our experience, TachoSil appears to be a satisfactory option for the management of these complications.
硬脊膜前撕裂合并脑脊液（CSF）漏和前脑膜膨出很少见。事实上，在文献中，有在前方融合术期间描述的病例，但没有描述颈椎置换术后的病例。这种类型并发症的处理方法描述得很差，也没有共识。我们报告了 1 例患者，在第 1 次手术后 1 个月发生颈椎置换术后前脑膜膨出。影像学显示与临床进行性恶化相关的有压迫性的前脑膜膨出。翻修手术包括用脂肪贴片覆盖 TachoSil 贴片关闭间隙，然后重新插入新的颈椎假体。在 1 年的最后一次随访中，患者没有出现并发症的残留影响，椎间盘假体的活动不受影响。关节置换术的临床结果也非常满意。尽管这些类型的并发症很少见，但有必要就前脑膜膨出的处理达成共识。根据我们的经验，TachoSil 似乎是处理这些并发症的一种令人满意的选择。
