Late Postoperative Cervical Spinal Cord Herniation with Pseudomeningocele.

Abstract

We report a middle-aged man with a history of traumatic cervical spinal cord injury with extensive edema. Decompressive surgery of posterior laminectomy and fixation was performed. An irreparable dural rupture on dorsal-lateral side of the cord was found during operation. The patient was managed with a myofascial and fibrin glue assisted closure and underwent watertight closure of fascia and skin. No cerebrospinal fluid leakage was detected in the postoperative period and the wound was healing, thus the patient was discharged. Clinical symptoms resolved. Half a year later, however, the patient presented with C5 nerve palsy. Magnetic resonance imaging revealed cervical spinal cord herniation with pseudomeningocele. Late postoperative cervical spinal cord herniation with pseudomeningocele may occur in any cervical spine trauma cases with dural rupture and/or defect, and close follow-up and observation are needed in the postoperative period.