Intravertebral pseudomeningocele: an unusual complication after disc surgery.

Abstract

Pseudomeningoceles are most commonly the result of dural tear during spine surgery. They may sometimes slowly enlarge but they generally develop inside the spinal canal, toward the foramina or toward the surgical incision. To describe a late and exceptional complication of a surgical discectomy. A case report. We report a unique case of a large asymptomatic pseudomeningocele strictly developed in the L5 vertebra, discovered incidentally in a 38-year-old woman. Computed tomography and magnetic resonance imaging showed a large cystic lesion involving the vertebral body and the left pedicle of L5 without contrast enhancement. There was neither extension of the cyst toward the vertebral lamina nor toward the spinal canal. Consent to publish the data was obtained from our patient. Diagnosis was performed during transpedicular image-guided puncture, when opacification of the cyst revealed dural communication. Biochemical analysis and cytology confirmed the presence of cerebrospinal fluid and absence of tumoral cells. Dural tear was considered as a neglected complication after surgical discectomy at the same level performed 18 years ago. Differential diagnoses of cystic spinal lesions are discussed.